ReceivedClaimFact

Properties

Reporting table name
dbo.ReceivedClaimFact
Granularity
A received claim, which can be an original, reversal, or adjustment claim
Profile tables
none
Links to
  1. ContractBridge
  2. ContractDim
  3. ContractDimSourceData
  4. CoverageDim
  5. DateDim
  6. DepartmentBridge
  7. DepartmentDim
  8. DiagnosisBridge
  9. DiagnosisDim
  10. DrgDim
  11. LineOfBusinessDim
  12. PatientDim
  13. PatientDimSourceData
  14. PlaceOfServiceDim
  15. ProcedureDim
  16. ProcedureTerminologyBridge
  17. ProviderDim
  18. ProviderDimSourceData
  19. ReceivedClaimFact
  20. SourceDim
  21. VendorDim
Links from
  1. AccumulationInstanceFact
  2. ApClaimActionFact
  3. ApClaimFact
  4. ApClaimProcessingCodeAuditFact
  5. ApClaimWorkqueueItemFact
  6. InterfaceLoadedClaimFact
  7. ManagedCareTransactionFact
  8. QdmDiagnosisEventFact
  9. QdmDiagnosticStudyPerformedEventFact
  10. QdmEncounterPerformedDiagnosisFact
  11. QdmEncounterPerformedSetDataMart
  12. QdmImmunizationAdministeredEventFact
  13. QdmInterventionPerformedEventFact
  14. QdmPhysicalExamPerformedEventFact
  15. QdmProcedurePerformedEventFact
  16. QdmSymptomEventFact
  17. QmEncounterClaimMappingFact
  18. QmEncounterIdentifierFact
  19. ReceivedClaimAnalyticsDataMart
  20. ReceivedClaimAttributeValueDim
  21. ReceivedClaimMedicationFact
  22. ReceivedClaimProcedureFact
  23. ReceivedClaimReferralMappingFact
  24. ValueBasedPaymentEventFact
Snapshot on data change
Disabled
  • Columns

    ReceivedClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No

    OriginalClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR Home Health Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR Hospice Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR Part B Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Facility Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    Data Aggregation Medical Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    OriginalClaimId
    OriginalClaimIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    OriginalClaimId
    OriginalClaimIdType

    "NotApplicable"

    Payer System Medical Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    Payer System Pharmacy Claim Load
    OriginalClaimId
    OriginalClaimIdType

    "NotApplicable"

    Received Claim Load
    OriginalClaimId

    NULL

    OriginalClaimIdType

    "NotApplicable"

    Received Pharmacy Claim Load
    OriginalClaimId
    OriginalClaimIdType

    "NotApplicable"

    AdjustmentToClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    CMS CJR Part B Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdjustmentToClaimId

    NULL

    AdjustmentToClaimIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    AdjustmentToClaimId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then AP_CLAIM.ORIG_ADJST_CLM_ID Otherwise if AP_CLAIM.REV_CLM_ID is NULL then AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID Otherwise NULL

    AdjustmentToClaimIdType
    AP_CLAIM.ORIG_ADJST_CLM_ID

    "EpicExternallyPaidClaimDataAggId"

    Data Aggregation Pharmacy Claim Load
    AdjustmentToClaimId
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AdjustmentToClaimIdType

    "EpicExternallyPaidPharmacyClaimDataAggId"

    Externally Adjudicated Medical Claim Load
    AdjustmentToClaimId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AdjustmentToClaimIdType

    "EpicExternalPaidClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    AdjustmentToClaimId
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AdjustmentToClaimIdType

    "EpicExternalPaidPharmacyClaimInformationId"

    Payer System Medical Claim Load
    AdjustmentToClaimId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then AP_CLAIM.ORIG_ADJST_CLM_ID Otherwise if AP_CLAIM.REV_CLM_ID is NULL then AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID Otherwise NULL

    AdjustmentToClaimIdType
    AP_CLAIM.ORIG_ADJST_CLM_ID

    "EpicExternalPaidPayerSystemClaimId"

    Payer System Pharmacy Claim Load
    AdjustmentToClaimId
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AdjustmentToClaimIdType

    "EpicExternalPaidPayerSystemPharmacyClaimId"

    Received Claim Load
    AdjustmentToClaimId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then AP_CLAIM.ORIG_ADJST_CLM_ID Otherwise if AP_CLAIM.REV_CLM_ID is NULL then AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID Otherwise NULL

    AdjustmentToClaimIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    AdjustmentToClaimId
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AdjustmentToClaimIdType

    "EpicPharmacyClaimInformationId"

    ReversalToClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    CMS CJR Part B Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReversalToClaimId

    NULL

    ReversalToClaimIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    ReversalToClaimId
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversalToClaimIdType
    AP_CLAIM.ORIG_REV_CLM_ID

    "EpicExternallyPaidClaimDataAggId"

    Data Aggregation Pharmacy Claim Load
    ReversalToClaimId
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    ReversalToClaimIdType

    "EpicExternallyPaidPharmacyClaimDataAggId"

    Externally Adjudicated Medical Claim Load
    ReversalToClaimId
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversalToClaimIdType

    "EpicExternalPaidClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    ReversalToClaimId
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    ReversalToClaimIdType

    "EpicExternalPaidPharmacyClaimInformationId"

    Payer System Medical Claim Load
    ReversalToClaimId
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversalToClaimIdType
    AP_CLAIM.ORIG_REV_CLM_ID

    "EpicExternalPaidPayerSystemClaimId"

    Payer System Pharmacy Claim Load
    ReversalToClaimId
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    ReversalToClaimIdType

    "EpicExternalPaidPayerSystemPharmacyClaimId"

    Received Claim Load
    ReversalToClaimId
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversalToClaimIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    ReversalToClaimId
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    ReversalToClaimIdType

    "EpicPharmacyClaimInformationId"

    AdjustedByClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    CMS CJR Part B Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdjustedByClaimId

    NULL

    AdjustedByClaimIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    AdjustedByClaimId
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.STATUS_C
    AP_CLAIM_2.CLAIM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If there exists any claim with AP_CLAIM.STATUS_C of 1-New, 2-Pending, 3-Denied, or 4-Clean and AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID = AP_CLAIM.CLAIM_ID of this row then the maximum AP_CLAIM.CLAIM_ID of that set Otherwise AP_CLAIM.ADJST_CLM_ID

    AdjustedByClaimIdType
    AP_CLAIM.ADJST_CLM_ID

    "EpicExternallyPaidClaimDataAggId"

    Data Aggregation Pharmacy Claim Load
    AdjustedByClaimId
    AP_CLM_RX.ADJUST_BY_CLAIM_ID
    AdjustedByClaimIdType

    "EpicExternallyPaidPharmacyClaimDataAggId"

    Externally Adjudicated Medical Claim Load
    AdjustedByClaimId
    AP_CLAIM.ADJST_CLM_ID
    AdjustedByClaimIdType

    "EpicExternalPaidClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    AdjustedByClaimId
    AP_CLM_RX.ADJUST_BY_CLAIM_ID
    AdjustedByClaimIdType

    "EpicExternalPaidPharmacyClaimInformationId"

    Payer System Medical Claim Load
    AdjustedByClaimId
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.STATUS_C
    AP_CLAIM_2.CLAIM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If there exists any claim with AP_CLAIM.STATUS_C of 1-New, 2-Pending, 3-Denied, or 4-Clean and AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID = AP_CLAIM.CLAIM_ID of this row then the maximum AP_CLAIM.CLAIM_ID of that set Otherwise AP_CLAIM.ADJST_CLM_ID

    AdjustedByClaimIdType
    AP_CLAIM.ADJST_CLM_ID

    "EpicExternalPaidPayerSystemClaimId"

    Payer System Pharmacy Claim Load
    AdjustedByClaimId
    AP_CLM_RX.ADJUST_BY_CLAIM_ID
    AdjustedByClaimIdType

    "EpicExternalPaidPayerSystemPharmacyClaimId"

    Received Claim Load
    AdjustedByClaimId
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.STATUS_C
    AP_CLAIM_2.CLAIM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If there exists any claim with AP_CLAIM.STATUS_C of 1-New, 2-Pending, 3-Denied, or 4-Clean and AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID = AP_CLAIM.CLAIM_ID of this row then the maximum AP_CLAIM.CLAIM_ID of that set Otherwise AP_CLAIM.ADJST_CLM_ID

    AdjustedByClaimIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    AdjustedByClaimId
    AP_CLM_RX.ADJUST_BY_CLAIM_ID
    AdjustedByClaimIdType

    "EpicPharmacyClaimInformationId"

    ReversedByClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR Home Health Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR Hospice Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR Part B Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Facility Claim Load
    ReversedByClaimId

    NULL

    ReversedByClaimIdType

    "NotApplicable"

    Data Aggregation Medical Claim Load
    ReversedByClaimId
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversedByClaimIdType
    AP_CLAIM.CLAIM_ID

    "EpicExternallyPaidClaimDataAggId"

    Data Aggregation Pharmacy Claim Load
    ReversedByClaimId
    AP_CLM_RX.CLAIM_ID
    ReversedByClaimIdType

    "EpicExternallyPaidPharmacyClaimDataAggId"

    Externally Adjudicated Medical Claim Load
    ReversedByClaimId
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversedByClaimIdType

    "EpicExternalPaidClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    ReversedByClaimId
    AP_CLM_RX.CLAIM_ID
    ReversedByClaimIdType

    "EpicExternalPaidPharmacyClaimInformationId"

    Payer System Medical Claim Load
    ReversedByClaimId
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversedByClaimIdType
    AP_CLAIM.CLAIM_ID

    "EpicExternalPaidPayerSystemClaimId"

    Payer System Pharmacy Claim Load
    ReversedByClaimId
    AP_CLM_RX.CLAIM_ID
    ReversedByClaimIdType

    "EpicExternalPaidPayerSystemPharmacyClaimId"

    Received Claim Load
    ReversedByClaimId
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    ReversedByClaimIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    ReversedByClaimId
    AP_CLM_RX.CLAIM_ID
    ReversedByClaimIdType

    "EpicPharmacyClaimInformationId"

    PayerClaimId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PayerClaimId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    CMS ACO Part B DME File Load
    PayerClaimId
    MsspPartBDme.CUR_CLM_UNIQ_ID
    CMS ACO Part B Physicians File Load
    PayerClaimId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    CMS ACO Part D Prescription Drug File Load
    PayerClaimId
    MsspPartD.CUR_CLM_UNIQ_ID
    CMS CJR DME Claim Load
    PayerClaimId
    CmsCjrDmeHeader.CLM_DT_SGNTR_SK
    CmsCjrDmeHeader.CLM_NUM_SK
    CmsCjrDmeHeader.CLM_TYPE_CD
    CmsCjrDmeHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Home Health Claim Load
    PayerClaimId
    CmsCjrHomeHealthHeader.CLM_DT_SGNTR_SK
    CmsCjrHomeHealthHeader.CLM_NUM_SK
    CmsCjrHomeHealthHeader.CLM_TYPE_CD
    CmsCjrHomeHealthHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Hospice Claim Load
    PayerClaimId
    CmsCjrHospiceHeader.CLM_DT_SGNTR_SK
    CmsCjrHospiceHeader.CLM_NUM_SK
    CmsCjrHospiceHeader.CLM_TYPE_CD
    CmsCjrHospiceHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Inpatient Claim Load
    PayerClaimId
    CmsCjrInpatientHeader.CLM_DT_SGNTR_SK
    CmsCjrInpatientHeader.CLM_NUM_SK
    CmsCjrInpatientHeader.CLM_TYPE_CD
    CmsCjrInpatientHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Outpatient Claim Load
    PayerClaimId
    CmsCjrOutpatientHeader.CLM_DT_SGNTR_SK
    CmsCjrOutpatientHeader.CLM_NUM_SK
    CmsCjrOutpatientHeader.CLM_TYPE_CD
    CmsCjrOutpatientHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Part B Claim Load
    PayerClaimId
    CmsCjrPartBHeader.CLM_DT_SGNTR_SK
    CmsCjrPartBHeader.CLM_NUM_SK
    CmsCjrPartBHeader.CLM_TYPE_CD
    CmsCjrPartBHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Skilled Nursing Facility Claim Load
    PayerClaimId
    CmsCjrSkilledNursingHeader.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingHeader.CLM_NUM_SK
    CmsCjrSkilledNursingHeader.CLM_TYPE_CD
    CmsCjrSkilledNursingHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    Data Aggregation Medical Claim Load
    PayerClaimId
    CLM_VALUES.ICN
    Data Aggregation Pharmacy Claim Load
    PayerClaimId
    CLM_VALUES.ICN
    Externally Adjudicated Medical Claim Load
    PayerClaimId
    CLM_VALUES.ICN

    CLM_VALUES.ICN

    Externally Adjudicated Pharmacy Claim Load
    PayerClaimId
    CLM_VALUES.ICN

    CLM_VALUES.ICN

    Payer System Medical Claim Load
    PayerClaimId
    CLM_VALUES.ICN
    Payer System Pharmacy Claim Load
    PayerClaimId
    CLM_VALUES.ICN
    Received Claim Load
    PayerClaimId
    AP_CLAIM.ACCT_NUM_WITH_VEN
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.WORKFLOW_C

    If AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then AP_CLAIM.ACCT_NUM_WITH_VEN Otherwise AP_CLAIM.CLAIM_ID

    Received Pharmacy Claim Load
    PayerClaimId
    AP_CLM_RX.CLAIM_ID

    AP_CLM_RX.CLAIM_ID

    PatientKey

    : integer
    Links to PatientDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientId
    MsspPartAClaimsHeader.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    PatientId
    MsspPartBDme.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    PatientId
    MsspPartBPhysicians.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    PatientId
    MsspPartD.BENE_HIC_NUM
    PatientIdType

    "EpicPatientHicn"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    PatientId
    CmsCjrDmeHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    PatientId
    CmsCjrHomeHealthHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    PatientId
    CmsCjrHospiceHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    PatientId
    CmsCjrInpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    PatientId
    CmsCjrOutpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    PatientId
    CmsCjrPartBHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    PatientId
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID
    AP_CLM_RX_2.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    PatientDurableKey

    : integer
    Links to PatientDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientId
    MsspPartAClaimsHeader.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS ACO Part B DME File Load
    PatientId
    MsspPartBDme.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS ACO Part B Physicians File Load
    PatientId
    MsspPartBPhysicians.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS ACO Part D Prescription Drug File Load
    PatientId
    MsspPartD.BENE_HIC_NUM
    PatientIdType

    "EpicPatientHicn"

    CMS CJR DME Claim Load
    PatientId
    CmsCjrDmeHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Home Health Claim Load
    PatientId
    CmsCjrHomeHealthHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Hospice Claim Load
    PatientId
    CmsCjrHospiceHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Inpatient Claim Load
    PatientId
    CmsCjrInpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Outpatient Claim Load
    PatientId
    CmsCjrOutpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Part B Claim Load
    PatientId
    CmsCjrPartBHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Skilled Nursing Facility Claim Load
    PatientId
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    Data Aggregation Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Data Aggregation Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Externally Adjudicated Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Externally Adjudicated Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID
    AP_CLM_RX_2.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Payer System Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Payer System Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Received Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Received Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientId
    MsspPartAClaimsHeader.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS ACO Part B DME File Load
    PatientId
    MsspPartBDme.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS ACO Part B Physicians File Load
    PatientId
    MsspPartBPhysicians.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS ACO Part D Prescription Drug File Load
    PatientId
    MsspPartD.BENE_HIC_NUM
    PatientIdType

    "EpicPatientHicn"

    PatientSourceName

    NULL (use source of the package)

    CMS CJR DME Claim Load
    PatientId
    CmsCjrDmeHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Home Health Claim Load
    PatientId
    CmsCjrHomeHealthHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Hospice Claim Load
    PatientId
    CmsCjrHospiceHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Inpatient Claim Load
    PatientId
    CmsCjrInpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Outpatient Claim Load
    PatientId
    CmsCjrOutpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Part B Claim Load
    PatientId
    CmsCjrPartBHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Skilled Nursing Facility Claim Load
    PatientId
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    Data Aggregation Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Data Aggregation Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName
    Externally Adjudicated Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Externally Adjudicated Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID
    AP_CLM_RX_2.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName
    Payer System Medical Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Payer System Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName
    Received Claim Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Received Pharmacy Claim Load
    PatientId
    AP_CLM_RX.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLM_RX.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    PrimaryCoverageKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrimaryCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL

    PrimaryCoverageIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    PrimaryCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL

    PrimaryCoverageIdType
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part B Physicians File Load
    PrimaryCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL

    PrimaryCoverageIdType
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PrimaryCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId

    CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface

    PrimaryCoverageIdType

    "EpicPayorId"

    CMS CJR DME Claim Load
    PrimaryCoverageId
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable

    PrimaryCoverageIdType
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable

    CMS CJR Home Health Claim Load
    PrimaryCoverageId
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Hospice Claim Load
    PrimaryCoverageId
    CmsCjrHospiceHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrHospiceHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Inpatient Claim Load
    PrimaryCoverageId
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Outpatient Claim Load
    PrimaryCoverageId
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Part B Claim Load
    PrimaryCoverageId
    CmsCjrPartBHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable

    PrimaryCoverageIdType
    CmsCjrPartBHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    PrimaryCoverageId
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    Data Aggregation Medical Claim Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    PrimaryCoverageId
    AP_CLM_RX_2.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLM_RX_2.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Externally Adjudicated Medical Claim Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID

    AP_CLAIM_3.PRIM_PAYOR_ID

    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If AP_CLAIM_3.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    PrimaryCoverageId
    AP_CLM_RX_2.PRIM_PAYOR_ID

    AP_CLM_RX_2.PRIM_PAYOR_ID

    PrimaryCoverageIdType
    AP_CLM_RX_2.PRIM_PAYOR_ID

    If AP_CLM_RX_2.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"'

    Payer System Medical Claim Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Payer System Pharmacy Claim Load
    PrimaryCoverageId
    AP_CLM_RX_2.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLM_RX_2.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Received Claim Load
    PrimaryCoverageId
    AP_CLAIM.COVERAGE_ID
    PrimaryCoverageIdType

    "EpicCoverageId"

    Received Pharmacy Claim Load
    PrimaryCoverageId
    AP_CLM_RX.COVERAGE_ID
    PrimaryCoverageIdType

    "EpicCoverageId"

    SecondCoverageKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface

    SecondCoverageIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS ACO Part B DME File Load
    SecondCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface

    SecondCoverageIdType
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS ACO Part B Physicians File Load
    SecondCoverageId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface

    SecondCoverageIdType
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS ACO Part D Prescription Drug File Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    SecondCoverageId
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId

    CMS CJR Home Health Claim Load
    SecondCoverageId
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Hospice Claim Load
    SecondCoverageId
    CmsCjrHospiceHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrHospiceHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Inpatient Claim Load
    SecondCoverageId
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Outpatient Claim Load
    SecondCoverageId
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Part B Claim Load
    SecondCoverageId
    CmsCjrPartBHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrPartBHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId

    CMS CJR Skilled Nursing Facility Claim Load
    SecondCoverageId
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    Data Aggregation Medical Claim Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    SecondCoverageId
    SecondCoverageIdType

    "Unspecified"

    Externally Adjudicated Medical Claim Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    SecondCoverageId
    SecondCoverageIdType

    "Unspecified"

    Payer System Medical Claim Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Payer System Pharmacy Claim Load
    SecondCoverageId
    SecondCoverageIdType

    "Unspecified"

    Received Claim Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Received Pharmacy Claim Load
    SecondCoverageId
    SecondCoverageIdType

    "Unspecified"

    ThirdCoverageKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Part B Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    ThirdCoverageId
    ThirdCoverageIdType

    "Unspecified"

    Externally Adjudicated Medical Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    ThirdCoverageId
    ThirdCoverageIdType

    "Unspecified"

    Payer System Medical Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Payer System Pharmacy Claim Load
    ThirdCoverageId
    ThirdCoverageIdType

    "Unspecified"

    Received Claim Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Received Pharmacy Claim Load
    ThirdCoverageId
    ThirdCoverageIdType

    "Unspecified"

    AttributedRegionKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttributedRegionId

    NULL

    AttributedRegionIdType

    "Unspecified"

    CMS ACO Part B DME File Load
    AttributedRegionId

    NULL

    AttributedRegionIdType

    "Unspecified"

    CMS ACO Part B Physicians File Load
    AttributedRegionId

    NULL

    AttributedRegionIdType

    "Unspecified"

    CMS ACO Part D Prescription Drug File Load
    AttributedRegionId

    NULL

    AttributedRegionIdType

    "Unspecified"

    CMS CJR DME Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    CMS CJR Home Health Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    CMS CJR Hospice Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    CMS CJR Inpatient Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    CMS CJR Outpatient Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    CMS CJR Part B Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    CMS CJR Skilled Nursing Facility Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType
    Data Aggregation Medical Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType

    "Unspecified"

    Data Aggregation Pharmacy Claim Load
    AttributedRegionId

    NULL

    AttributedRegionIdType

    "Unspecified"

    Externally Adjudicated Medical Claim Load
    AttributedRegionId
    AP_CLAIM_3.REGION_ID
    AttributedRegionIdType

    "EpicFacilityProfileId"

    Externally Adjudicated Pharmacy Claim Load
    AttributedRegionId
    AP_CLM_RX_2.REGION_ID
    AttributedRegionIdType
    Received Claim Load
    AttributedRegionId
    AP_CLAIM_3.REGION_ID
    AttributedRegionIdType
    Received Pharmacy Claim Load
    AttributedRegionId
    AP_CLM_RX_2.REGION_ID
    AttributedRegionIdType

    AttributedMedicalGroupKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType

    "Unspecified"

    CMS ACO Part B DME File Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType

    "Unspecified"

    CMS ACO Part B Physicians File Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType

    "Unspecified"

    CMS ACO Part D Prescription Drug File Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType

    "Unspecified"

    CMS CJR DME Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    CMS CJR Home Health Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    CMS CJR Hospice Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    CMS CJR Inpatient Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    CMS CJR Outpatient Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    CMS CJR Part B Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    CMS CJR Skilled Nursing Facility Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType
    Data Aggregation Medical Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType

    "Unspecified"

    Data Aggregation Pharmacy Claim Load
    AttributedMedicalGroupId

    NULL

    AttributedMedicalGroupIdType

    "Unspecified"

    Externally Adjudicated Medical Claim Load
    AttributedMedicalGroupId
    AP_CLAIM_3.MEDICAL_GROUP_ID
    AttributedMedicalGroupIdType

    "EpicFacilityProfileId"

    Externally Adjudicated Pharmacy Claim Load
    AttributedMedicalGroupId
    AP_CLM_RX_2.MEDICAL_GROUP_ID
    AttributedMedicalGroupIdType
    Received Claim Load
    AttributedMedicalGroupId
    AP_CLAIM_3.MEDICAL_GROUP_ID
    AttributedMedicalGroupIdType
    Received Pharmacy Claim Load
    AttributedMedicalGroupId
    AP_CLM_RX_2.MEDICAL_GROUP_ID
    AttributedMedicalGroupIdType

    BenefitPlanKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BenefitPlanId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.BenefitPlanDefaultId

    Benefit plan as configured through interface configuration in Chronicles

    BenefitPlanIdType

    "EpicBenefitPlanId"

    CMS ACO Part B DME File Load
    BenefitPlanId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.BenefitPlanDefaultId

    Benefit plan as configured through interface configuration in Chronicles

    BenefitPlanIdType

    "EpicBenefitPlanId"

    CMS ACO Part B Physicians File Load
    BenefitPlanId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.BenefitPlanDefaultId

    Benefit plan as configured through interface configuration in Chronicles

    BenefitPlanIdType

    "EpicBenefitPlanId"

    CMS ACO Part D Prescription Drug File Load
    BenefitPlanId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.BenefitPlanDefaultId

    Benefit plan as configured through interface configuration in Chronicles

    BenefitPlanIdType

    "EpicBenefitPlanId"

    CMS CJR DME Claim Load
    BenefitPlanId
    BenefitPlanIdType
    CMS CJR Home Health Claim Load
    BenefitPlanId
    BenefitPlanIdType
    CMS CJR Hospice Claim Load
    BenefitPlanId
    BenefitPlanIdType
    CMS CJR Inpatient Claim Load
    BenefitPlanId
    BenefitPlanIdType
    CMS CJR Outpatient Claim Load
    BenefitPlanId
    BenefitPlanIdType
    CMS CJR Part B Claim Load
    BenefitPlanId
    BenefitPlanIdType
    CMS CJR Skilled Nursing Facility Claim Load
    BenefitPlanId
    BenefitPlanIdType
    Data Aggregation Medical Claim Load
    BenefitPlanId
    AP_CLAIM.BENEFIT_PLAN_ID
    BenefitPlanIdType
    AP_CLAIM.BENEFIT_PLAN_ID

    "EpicBenefitPlanId"

    Data Aggregation Pharmacy Claim Load
    BenefitPlanId
    AP_CLM_RX_2.BENEFIT_PLAN_ID
    BenefitPlanIdType
    AP_CLM_RX_2.BENEFIT_PLAN_ID

    "EpicBenefitPlanId"

    Externally Adjudicated Medical Claim Load
    BenefitPlanId
    AP_CLAIM.BENEFIT_PLAN_ID
    BenefitPlanIdType

    "EpicBenefitPlanId"

    Externally Adjudicated Pharmacy Claim Load
    BenefitPlanId
    BenefitPlanIdType

    "Unspecified"

    Payer System Medical Claim Load
    BenefitPlanId
    AP_CLAIM.BENEFIT_PLAN_ID
    BenefitPlanIdType
    AP_CLAIM.BENEFIT_PLAN_ID

    "EpicBenefitPlanId"

    Payer System Pharmacy Claim Load
    BenefitPlanId
    AP_CLM_RX_2.BENEFIT_PLAN_ID
    BenefitPlanIdType
    AP_CLM_RX_2.BENEFIT_PLAN_ID

    "EpicBenefitPlanId"

    Received Claim Load
    BenefitPlanId
    AP_CLAIM.BENEFIT_PLAN_ID
    BenefitPlanIdType

    "EpicBenefitPlanId"

    Received Pharmacy Claim Load
    BenefitPlanId
    BenefitPlanIdType

    "Unspecified"

    PayerKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PayerId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL

    PayerIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    PayerId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL

    PayerIdType
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part B Physicians File Load
    PayerId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact or payer configured in the Chronicles interface Otherwise NULL

    PayerIdType
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PayerId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.PayerDefaultId

    Payor as configured through ReceivedClaimFact Component Configuration or through interface configuration in Chronicles

    PayerIdType

    "EpicPayorId"

    CMS CJR DME Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    CMS CJR Part B Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    PayerId

    NULL

    PayerIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    PayerId
    AP_CLAIM.WORKFLOW_PAYOR_ID

    If WORKFLOW_PAYOR_ID is not NULL then WORKFLOW_PAYOR_ID Otherwise NULL

    PayerIdType
    AP_CLAIM.WORKFLOW_PAYOR_ID

    If WORKFLOW_PAYER_ID is not null then "EpicPayorId" Otherwise "NotApplciable"

    Data Aggregation Pharmacy Claim Load
    PayerId
    AP_CLM_RX_2.WORKFLOW_PAYOR_ID
    PayerIdType

    "EpicPayorId"

    Externally Adjudicated Medical Claim Load
    PayerId
    PayerIdType

    "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    PayerId
    PayerIdType

    "Unspecified"

    Payer System Medical Claim Load
    PayerId
    AP_CLAIM.WORKFLOW_PAYOR_ID

    If WORKFLOW_PAYOR_ID is not NULL then WORKFLOW_PAYOR_ID Otherwise NULL

    PayerIdType
    AP_CLAIM.WORKFLOW_PAYOR_ID

    If WORKFLOW_PAYER_ID is not null then "EpicPayorId" Otherwise "NotApplciable"

    Payer System Pharmacy Claim Load
    PayerId
    AP_CLM_RX_2.WORKFLOW_PAYOR_ID
    PayerIdType

    "EpicPayorId"

    Received Claim Load
    PayerId
    AP_CLAIM.PLAN_GROUP_ID
    AP_CLAIM.SERV_DATE
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.WORKFLOW_PAYOR_ID
    PLAN_GRP_BEN_PLAN.BEN_PLAN_PAYOR_ID

    If WORKFLOW_PAYOR_ID is not NULL then WORKFLOW_PAYOR_ID Otherwise if there does not exist a row in PLAN_GRP_BEN_PLAN for AP_CLAIM.PLAN_GROUP_ID effective on SERVICE_START_DATE if populated, SERV_DATE if not, then "*Unspecified" Otherwise PLAN_GRP_BEN_PLAN.BEN_PLAN_PAYOR_ID

    PayerIdType

    "EpicPayorId"

    Received Pharmacy Claim Load
    PayerId
    PayerIdType

    "Unspecified"

    VendorKey

    : integer
    Links to VendorDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    VendorId

    NULL

    VendorIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    VendorId

    NULL

    VendorIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    VendorId

    NULL

    VendorIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    VendorId

    NULL

    VendorIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    CMS CJR Part B Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    VendorId

    NULL

    VendorIdType

    NotApplicable

    Data Aggregation Pharmacy Claim Load
    VendorId
    VendorIdType

    "Unspecified"

    Externally Adjudicated Medical Claim Load
    VendorId
    AP_CLAIM.VENDOR_ID
    VendorIdType

    "EpicVendorId"

    Externally Adjudicated Pharmacy Claim Load
    VendorId
    VendorIdType

    "Unspecified"

    Payer System Pharmacy Claim Load
    VendorId
    VendorIdType

    "Unspecified"

    Received Claim Load
    VendorId
    AP_CLAIM.VENDOR_ID
    VendorIdType

    "EpicVendorId"

    Received Pharmacy Claim Load
    VendorId
    VendorIdType

    "Unspecified"

    PlaceOfServiceKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PlaceOfServiceId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    PlaceOfServiceIdType

    "FacilityNpi"

    CMS ACO Part B DME File Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    PlaceOfServiceId
    CmsCjrHomeHealthHeader.ORGNPINM
    PlaceOfServiceIdType

    FacilityNpi

    CMS CJR Hospice Claim Load
    PlaceOfServiceId
    CmsCjrHospiceHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    CMS CJR Inpatient Claim Load
    PlaceOfServiceId
    CmsCjrInpatientHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    CMS CJR Outpatient Claim Load
    PlaceOfServiceId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    CMS CJR Part B Claim Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    PlaceOfServiceId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    Data Aggregation Medical Claim Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Data Aggregation Pharmacy Claim Load
    PlaceOfServiceId
    PlaceOfServiceIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Externally Adjudicated Pharmacy Claim Load
    PlaceOfServiceId
    PlaceOfServiceIdType

    "NotApplicable"

    Payer System Medical Claim Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Payer System Pharmacy Claim Load
    PlaceOfServiceId
    PlaceOfServiceIdType

    "NotApplicable"

    Received Claim Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Received Pharmacy Claim Load
    PlaceOfServiceId
    PlaceOfServiceIdType

    "NotApplicable"

    CcnPlaceOfServiceKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CcnPlaceOfServiceId
    MsspPartAClaimsHeader.PRVDR_OSCAR_NUM
    CcnPlaceOfServiceIdType

    "FacilityCcn"

    CMS ACO Part B DME File Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    CcnPlaceOfServiceId
    CmsCjrHomeHealthHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Hospice Claim Load
    CcnPlaceOfServiceId
    CmsCjrHospiceHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Inpatient Claim Load
    CcnPlaceOfServiceId
    CmsCjrInpatientHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Outpatient Claim Load
    CcnPlaceOfServiceId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Part B Claim Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    CcnPlaceOfServiceId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    Data Aggregation Medical Claim Load
    CcnPlaceOfServiceId
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Data Aggregation Pharmacy Claim Load
    CcnPlaceOfServiceId
    CcnPlaceOfServiceIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    CcnPlaceOfServiceId
    CcnPlaceOfServiceIdType

    "NotApplicable"

    Payer System Medical Claim Load
    CcnPlaceOfServiceId
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Payer System Pharmacy Claim Load
    CcnPlaceOfServiceId
    CcnPlaceOfServiceIdType

    "NotApplicable"

    Received Claim Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Received Pharmacy Claim Load
    CcnPlaceOfServiceId
    CcnPlaceOfServiceIdType

    "NotApplicable"

    BillingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    BillingProviderId
    CmsCjrHomeHealthHeader.ORGNPINM
    BillingProviderIdType

    FacilityNpi

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    BillingProviderId
    CmsCjrHospiceHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    BillingProviderId
    CmsCjrInpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    BillingProviderId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType
    CLM_VALUES.RECORD_ID

    "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    BillingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    BillingProviderId
    CmsCjrHomeHealthHeader.ORGNPINM
    BillingProviderIdType

    FacilityNpi

    CMS CJR Hospice Claim Load
    BillingProviderId
    CmsCjrHospiceHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    CMS CJR Inpatient Claim Load
    BillingProviderId
    CmsCjrInpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    CMS CJR Outpatient Claim Load
    BillingProviderId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    CMS CJR Part B Claim Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    Data Aggregation Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType
    CLM_VALUES.RECORD_ID

    "EpicProviderNpi"

    Data Aggregation Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    Payer System Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Payer System Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    Received Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Received Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName

    NULL

    CMS CJR DME Claim Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    BillingProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    BillingProviderId
    CmsCjrHomeHealthHeader.ORGNPINM
    BillingProviderIdType

    FacilityNpi

    BillingProviderSourceName

    "NPPES"

    CMS CJR Hospice Claim Load
    BillingProviderId
    CmsCjrHospiceHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    BillingProviderId
    CmsCjrInpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    "CMS"

    CMS CJR Outpatient Claim Load
    BillingProviderId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    "CMS"

    CMS CJR Part B Claim Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    BillingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    "CMS"

    Data Aggregation Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType
    CLM_VALUES.RECORD_ID

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Data Aggregation Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName
    Externally Adjudicated Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName
    Payer System Medical Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Payer System Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName
    Received Claim Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Received Pharmacy Claim Load
    BillingProviderId
    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName

    ReferringProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    ReferringProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Part B Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Data Aggregation Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    Payer System Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    Received Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS CJR DME Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Hospice Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Outpatient Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Part B Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    Data Aggregation Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName
    Externally Adjudicated Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName
    Payer System Medical Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName
    Received Claim Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Pharmacy Claim Load
    ReferringProviderId
    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    RenderingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    RenderingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Part B Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Data Aggregation Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    Payer System Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Payer System Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    Received Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Received Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS CJR DME Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Hospice Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Outpatient Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Part B Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    Data Aggregation Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Data Aggregation Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName
    Externally Adjudicated Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName
    Payer System Medical Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Payer System Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName
    Received Claim Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Received Pharmacy Claim Load
    RenderingProviderId
    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    AttendingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    AttendingProviderId
    CmsCjrHomeHealthHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    AttendingProviderId
    CmsCjrOutpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderId
    CmsCjrSkilledNursingHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    AttendingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    AttendingProviderId
    CmsCjrHomeHealthHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Hospice Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Outpatient Claim Load
    AttendingProviderId
    CmsCjrOutpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Part B Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderId
    CmsCjrSkilledNursingHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    Data Aggregation Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Data Aggregation Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    Payer System Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    Received Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    AttendingProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName

    NULL

    CMS CJR DME Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    AttendingProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    AttendingProviderId
    CmsCjrHomeHealthHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Hospice Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    AttendingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Outpatient Claim Load
    AttendingProviderId
    CmsCjrOutpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Part B Claim Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    AttendingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderId
    CmsCjrSkilledNursingHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    Data Aggregation Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName
    Externally Adjudicated Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName
    Payer System Medical Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName
    Received Claim Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Pharmacy Claim Load
    AttendingProviderId
    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName

    OperatingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    OperatingProviderId
    CmsCjrHomeHealthHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    OperatingProviderId
    CmsCjrOutpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderId
    CmsCjrSkilledNursingHeader.OP_NPI
    OperatingProviderIdType

    "EpicProviderNpi"

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    OperatingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    OperatingProviderId
    CmsCjrHomeHealthHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    CMS CJR Hospice Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    CMS CJR Outpatient Claim Load
    OperatingProviderId
    CmsCjrOutpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    CMS CJR Part B Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderId
    CmsCjrSkilledNursingHeader.OP_NPI
    OperatingProviderIdType

    "EpicProviderNpi"

    Data Aggregation Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Data Aggregation Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    Payer System Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    Received Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    OperatingProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName

    NULL

    CMS CJR DME Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    OperatingProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    OperatingProviderId
    CmsCjrHomeHealthHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Hospice Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    OperatingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Outpatient Claim Load
    OperatingProviderId
    CmsCjrOutpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Part B Claim Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    OperatingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderId
    CmsCjrSkilledNursingHeader.OP_NPI
    OperatingProviderIdType

    "EpicProviderNpi"

    OperatingProviderSourceName

    "NPPES"

    Data Aggregation Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName
    Externally Adjudicated Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName
    Payer System Medical Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName
    Received Claim Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Pharmacy Claim Load
    OperatingProviderId
    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName

    OtherProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    OtherProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Part B Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Data Aggregation Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    Payer System Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    Received Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    OtherProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName

    NULL

    CMS CJR DME Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Hospice Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Outpatient Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Part B Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    Data Aggregation Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName
    Externally Adjudicated Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName
    Payer System Medical Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName
    Received Claim Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Pharmacy Claim Load
    OtherProviderId
    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName

    PrescribingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    PrescribingProviderId
    MsspPartD.CLM_PRSBNG_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_PRSBNG_ID_QLFYR_CD

    If PRVDR_PRSBNG_ID_QLFYR_CD = 01-NPI Number then CLM_PRSBNG_PRVDR_GNRC_ID_NUM

    PrescribingProviderIdType

    "EpicProviderNpi"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    PrescribingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PrescribingProviderId
    MsspPartD.CLM_PRSBNG_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_PRSBNG_ID_QLFYR_CD

    If PRVDR_PRSBNG_ID_QLFYR_CD = 01-NPI Number then CLM_PRSBNG_PRVDR_GNRC_ID_NUM

    PrescribingProviderIdType

    "EpicProviderNpi"

    CMS CJR DME Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    CMS CJR Part B Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    Payer System Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    Received Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PrescribingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    PrescribingProviderId
    MsspPartD.CLM_PRSBNG_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_PRSBNG_ID_QLFYR_CD

    If PRVDR_PRSBNG_ID_QLFYR_CD = 01-NPI Number then CLM_PRSBNG_PRVDR_GNRC_ID_NUM

    PrescribingProviderIdType

    "EpicProviderNpi"

    PrescribingProviderSourceName

    "NPPES"

    CMS CJR DME Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    CMS CJR Hospice Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    CMS CJR Outpatient Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    CMS CJR Part B Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    NotApplicable

    PrescribingProviderSourceName

    NULL

    Data Aggregation Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    Data Aggregation Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PrescribingProviderSourceName
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PrescribingProviderSourceName
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Medical Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    Payer System Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PrescribingProviderSourceName
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim Load
    PrescribingProviderId

    NULL

    PrescribingProviderIdType

    "NotApplicable"

    PrescribingProviderSourceName

    NULL

    Received Pharmacy Claim Load
    PrescribingProviderId
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then PROV_IDENT Otherwise PRESC_PROV_ID

    PrescribingProviderIdType
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PrescribingProviderSourceName
    AP_CLM_RX.PRESC_PROV_ID
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT
    CLM_VALUES_PRESC_PROV_ID.PROV_IDENT_QUAL

    If PROV_IDENT_QUAL = "01" and PROV_IDENT is not NULL then "NPPES" Otherwise NULL (use source of the package)

    ServiceProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    ServiceProviderId
    MsspPartD.CLM_SRVC_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_SRVC_ID_QLFYR_CD

    If PRVDR_SRVC_ID_QLFYR_CD = 01-NPI Number then CLM_SRVC_PRVDR_GNRC_ID_NUM

    ServiceProviderIdType

    "EpicProviderNpi"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    ServiceProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    ServiceProviderId
    MsspPartD.CLM_SRVC_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_SRVC_ID_QLFYR_CD

    If PRVDR_SRVC_ID_QLFYR_CD = 01-NPI Number then CLM_SRVC_PRVDR_GNRC_ID_NUM

    ServiceProviderIdType

    "EpicProviderNpi"

    CMS CJR DME Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    CMS CJR Part B Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    Externally Adjudicated Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    Externally Adjudicated Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    Payer System Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    Payer System Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    Received Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    Received Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    ServiceProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    CMS ACO Part D Prescription Drug File Load
    ServiceProviderId
    MsspPartD.CLM_SRVC_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_SRVC_ID_QLFYR_CD

    If PRVDR_SRVC_ID_QLFYR_CD = 01-NPI Number then CLM_SRVC_PRVDR_GNRC_ID_NUM

    ServiceProviderIdType

    "EpicProviderNpi"

    ServiceProviderSourceName

    "NPPES"

    CMS CJR DME Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    CMS CJR Home Health Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    CMS CJR Hospice Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    CMS CJR Inpatient Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    CMS CJR Outpatient Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    CMS CJR Part B Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    NotApplicable

    ServiceProviderSourceName

    NULL

    Data Aggregation Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    Data Aggregation Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    ServiceProviderSourceName

    "NPPES"

    Externally Adjudicated Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    ServiceProviderSourceName

    "NPPES"

    Payer System Medical Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    Payer System Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    ServiceProviderSourceName

    "NPPES"

    Received Claim Load
    ServiceProviderId

    NULL

    ServiceProviderIdType

    "NotApplicable"

    ServiceProviderSourceName

    NULL

    Received Pharmacy Claim Load
    ServiceProviderId
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    ServiceProviderIdType
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "01" and SVC_PROV_IDENT is not NULL then "EpicProviderNpi" Otherwise "Unspecified"

    ServiceProviderSourceName

    "NPPES"

    DrgKey

    : integer
    Links to DrgDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DrgId

    This column isn't configured for use in reports. See an administrator for more information

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information

    CMS ACO Part B DME File Load
    DrgId

    NULL

    DrgIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    DrgId

    NULL

    DrgIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    DrgId

    NULL

    DrgIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    DrgId
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DRG_CD

    This column isn't configured for use in reports. See an administrator for more information.

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS CJR Outpatient Claim Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Part B Claim Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    DrgId
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DRG_CD

    This column isn't configured for use in reports. See an administrator for more information.

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information.

    Data Aggregation Medical Claim Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Data Aggregation Pharmacy Claim Load
    DrgId
    DrgIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Externally Adjudicated Pharmacy Claim Load
    DrgId
    DrgIdType

    "NotApplicable"

    Payer System Medical Claim Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Payer System Pharmacy Claim Load
    DrgId
    DrgIdType

    "NotApplicable"

    Received Claim Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Received Pharmacy Claim Load
    DrgId
    DrgIdType

    "NotApplicable"

    PrimaryDiagnosisKey

    : integer
    Links to DiagnosisDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrimaryDiagnosisId
    MsspPartAClaimsHeader.PRNCPL_DGNS_CD
    PrimaryDiagnosisIdType
    MsspPartAClaimsHeader.DGNS_PRCDR_ICD_IND
    MsspPartAClaimsHeader.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    PrimaryDiagnosisId

    NULL

    PrimaryDiagnosisIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PrimaryDiagnosisId
    MsspPartBPhysicians.CLM_DGNS_1_CD
    PrimaryDiagnosisIdType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and MsspPartBPhysicians.FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PrimaryDiagnosisId

    NULL

    PrimaryDiagnosisIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    PrimaryDiagnosisId
    CmsCjrDmeHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Home Health Claim Load
    PrimaryDiagnosisId
    CmsCjrHomeHealthHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Hospice Claim Load
    PrimaryDiagnosisId
    CmsCjrHospiceHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Inpatient Claim Load
    PrimaryDiagnosisId
    CmsCjrInpatientHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    CMS CJR Outpatient Claim Load
    PrimaryDiagnosisId
    CmsCjrOutpatientHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Part B Claim Load
    PrimaryDiagnosisId
    CmsCjrPartBHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    PrimaryDiagnosisId
    CmsCjrSkilledNursingHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    Data Aggregation Medical Claim Load
    PrimaryDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    PrimaryDiagnosisIdType
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID

    If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    PrimaryDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    PrimaryDiagnosisIdType

    "EpicDiagnosisId"

    Externally Adjudicated Medical Claim Load
    PrimaryDiagnosisId

    NULL

    PrimaryDiagnosisIdType

    "Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    PrimaryDiagnosisId
    PrimaryDiagnosisIdType

    "NotApplicable"

    Payer System Medical Claim Load
    PrimaryDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    PrimaryDiagnosisIdType
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID

    If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable"

    Payer System Pharmacy Claim Load
    PrimaryDiagnosisId
    PrimaryDiagnosisIdType

    "NotApplicable"

    Received Claim Load
    PrimaryDiagnosisId
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE

    DX_ID where LINE = 1

    PrimaryDiagnosisIdType

    "EpicDiagnosisId"

    Received Pharmacy Claim Load
    PrimaryDiagnosisId
    PrimaryDiagnosisIdType

    "NotApplicable"

    AdmittingDiagnosisKey

    : integer
    Links to DiagnosisDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmittingDiagnosisId
    MsspPartAClaimsHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    MsspPartAClaimsHeader.DGNS_PRCDR_ICD_IND
    MsspPartAClaimsHeader.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    AdmittingDiagnosisId
    CmsCjrInpatientHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    CmsCJrInpatientHeader.CLM_THRU_DT
    CmsCJrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    CMS CJR Outpatient Claim Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Part B Claim Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdmittingDiagnosisId
    CmsCjrSkilledNursingHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    Data Aggregation Medical Claim Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType
    AP_CLAIM.ADMISSION_DX_ID

    "EpicDiagnosisId"

    Data Aggregation Pharmacy Claim Load
    AdmittingDiagnosisId
    AdmittingDiagnosisIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    "EpicDiagnosisId"

    Externally Adjudicated Pharmacy Claim Load
    AdmittingDiagnosisId
    AdmittingDiagnosisIdType

    "NotApplicable"

    Payer System Medical Claim Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType
    AP_CLAIM.ADMISSION_DX_ID

    "EpicDiagnosisId"

    Payer System Pharmacy Claim Load
    AdmittingDiagnosisId
    AdmittingDiagnosisIdType

    "NotApplicable"

    Received Claim Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    "EpicDiagnosisId"

    Received Pharmacy Claim Load
    AdmittingDiagnosisId
    AdmittingDiagnosisIdType

    "NotApplicable"

    DiagnosisComboKey

    : integer
    Links to DiagnosisBridge

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DiagnosisComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    DiagnosisComboIdType

    "MsspClaimUniqueId"

    CMS ACO Part B DME File Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    DiagnosisComboId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    DiagnosisComboIdType

    "MsspClaimUniqueId"

    CMS ACO Part D Prescription Drug File Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Home Health Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Hospice Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Inpatient Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Outpatient Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Part B Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Skilled Nursing Facility Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    DiagnosisComboIdType

    CmsCjrUniqueClaimId

    Data Aggregation Medical Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    DiagnosisComboIdType

    "EpicClaimInformationId:ReceivedClaim"

    Data Aggregation Pharmacy Claim Load
    DiagnosisComboId
    AP_CLM_RX.CLAIM_ID
    DiagnosisComboIdType
    Externally Adjudicated Medical Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    DiagnosisComboIdType

    "EpicClaimInformationId:ReceivedClaim"

    Externally Adjudicated Pharmacy Claim Load
    DiagnosisComboId
    DiagnosisComboIdType

    "NotApplicable"

    Payer System Medical Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    DiagnosisComboIdType

    "EpicClaimInformationId:ReceivedClaim"

    Payer System Pharmacy Claim Load
    DiagnosisComboId
    AP_CLM_RX.CLAIM_ID
    DiagnosisComboIdType
    Received Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    DiagnosisComboIdType

    "EpicClaimInformationId:ReceivedClaim"

    Received Pharmacy Claim Load
    DiagnosisComboId
    DiagnosisComboIdType

    "NotApplicable"

    DiagnosisComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes

    DiagnosisNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes

    DiagnosisComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DiagnosisComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    CMS ACO Part B DME File Load
    DiagnosisComboId

    NULL

    CMS ACO Part B Physicians File Load
    DiagnosisComboId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    CMS ACO Part D Prescription Drug File Load
    DiagnosisComboId

    NULL

    CMS CJR DME Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Home Health Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Hospice Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Inpatient Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Outpatient Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Part B Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Skilled Nursing Facility Claim Load
    DiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    Data Aggregation Medical Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    Data Aggregation Pharmacy Claim Load
    DiagnosisComboId
    AP_CLM_RX.CLAIM_ID
    Externally Adjudicated Medical Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    Payer System Medical Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID
    Payer System Pharmacy Claim Load
    DiagnosisComboId
    AP_CLM_RX.CLAIM_ID
    Received Claim Load
    DiagnosisComboId
    AP_CLAIM.CLAIM_ID

    FirstDiagnosisKey

    : integer
    Links to DiagnosisDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstDiagnosisId
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 1

    FirstDiagnosisIdType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unspecified"

    CMS ACO Part B DME File Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    FirstDiagnosisId
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 1 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    FirstDiagnosisIdType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate <2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unspecified"

    CMS ACO Part D Prescription Drug File Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    FirstDiagnosisId

    If CODE_VALUE is not NULL then CODE_VALUE

    FirstDiagnosisIdType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL

    CMS CJR Home Health Claim Load
    FirstDiagnosisId

    If CODE_VALUE is not NULL then CODE_VALUE

    FirstDiagnosisIdType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL

    CMS CJR Hospice Claim Load
    FirstDiagnosisId

    If CODE_VALUE is not NULL then CODE_VALUE

    FirstDiagnosisIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL

    CMS CJR Inpatient Claim Load
    FirstDiagnosisId

    If CODE_VALUE is not NULL then CODE_VALUE

    FirstDiagnosisIdType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise NULL

    CMS CJR Outpatient Claim Load
    FirstDiagnosisId

    If CODE_VALUE is not NULL then CODE_VALUE

    FirstDiagnosisIdType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL

    CMS CJR Part B Claim Load
    FirstDiagnosisId

    If CODE_VALUE is not NULL then CODE_VALUE

    FirstDiagnosisIdType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise NULL

    CMS CJR Skilled Nursing Facility Claim Load
    FirstDiagnosisId
    CmsCjrSkilledNursingHeader.CODE_VALUE
    FirstDiagnosisIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise NULL

    Data Aggregation Medical Claim Load
    FirstDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    FirstDiagnosisIdType
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID

    If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    FirstDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    FirstDiagnosisIdType

    "EpicDiagnosisId"

    Externally Adjudicated Medical Claim Load
    FirstDiagnosisId
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE

    DX_ID where LINE = 1

    FirstDiagnosisIdType

    "EpicDiagnosisId"

    Externally Adjudicated Pharmacy Claim Load
    FirstDiagnosisId
    FirstDiagnosisIdType

    "NotApplicable"

    Payer System Medical Claim Load
    FirstDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    FirstDiagnosisIdType
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID

    If FIRSTDXID is not NULL then "EpicDiagnosisId" Otherwise "NotApplicable"

    Payer System Pharmacy Claim Load
    FirstDiagnosisId
    AP_CLAIM_DX.AP_DX_RANK
    AP_CLAIM_DX.DX_ID
    FirstDiagnosisIdType

    "EpicDiagnosisId"

    Received Claim Load
    FirstDiagnosisId
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE

    DX_ID where LINE = 1

    FirstDiagnosisIdType

    "EpicDiagnosisId"

    Received Pharmacy Claim Load
    FirstDiagnosisId
    FirstDiagnosisIdType

    "NotApplicable"

    PresentOnAdmissionDiagnosisComboKey

    : integer
    Links to DiagnosisBridge

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PresentOnAdmissionDiagnosisComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    PresentOnAdmissionDiagnosisComboIdType

    "CmsAcoPresentOnAdmissionClaimUniqueId"

    CMS ACO Part B DME File Load
    PresentOnAdmissionDiagnosisComboId

    NULL

    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PresentOnAdmissionDiagnosisComboId

    NULL

    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PresentOnAdmissionDiagnosisComboId

    NULL

    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    CMS CJR Home Health Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    CMS CJR Hospice Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    CMS CJR Inpatient Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    CMS CJR Outpatient Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    CMS CJR Part B Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    CMS CJR Skilled Nursing Facility Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    PresentOnAdmissionDiagnosisComboIdType

    CmsCjrUniqueClaimId:POA

    Data Aggregation Medical Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    PresentOnAdmissionDiagnosisComboIdType

    "EpicClaimInformationId:PresentOnAdmission"

    Data Aggregation Pharmacy Claim Load
    PresentOnAdmissionDiagnosisComboId
    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    PresentOnAdmissionDiagnosisComboIdType

    "EpicClaimInformationId:PresentOnAdmission"

    Externally Adjudicated Pharmacy Claim Load
    PresentOnAdmissionDiagnosisComboId
    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    Payer System Medical Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    PresentOnAdmissionDiagnosisComboIdType

    "EpicClaimInformationId:PresentOnAdmission"

    Payer System Pharmacy Claim Load
    PresentOnAdmissionDiagnosisComboId
    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    Received Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    PresentOnAdmissionDiagnosisComboIdType

    "EpicClaimInformationId:PresentOnAdmission"

    Received Pharmacy Claim Load
    PresentOnAdmissionDiagnosisComboId
    PresentOnAdmissionDiagnosisComboIdType

    "NotApplicable"

    PresentOnAdmissionDiagnosisComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes

    PresentOnAdmissionDiagnosisNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes

    PresentOnAdmissionDiagnosisComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PresentOnAdmissionDiagnosisComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    CMS ACO Part B DME File Load
    PresentOnAdmissionDiagnosisComboId

    NULL

    CMS ACO Part B Physicians File Load
    PresentOnAdmissionDiagnosisComboId

    NULL

    CMS ACO Part D Prescription Drug File Load
    PresentOnAdmissionDiagnosisComboId

    NULL

    CMS CJR DME Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Home Health Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Hospice Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Inpatient Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Outpatient Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Part B Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Skilled Nursing Facility Claim Load
    PresentOnAdmissionDiagnosisComboId

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    Data Aggregation Medical Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    Externally Adjudicated Medical Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    Payer System Medical Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID
    Received Claim Load
    PresentOnAdmissionDiagnosisComboId
    AP_CLAIM.CLAIM_ID

    SurgicalProcedureComboKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SurgicalProcedureComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    SurgicalProcedureComboIdType

    "MsspClaimUniqueId"

    CMS ACO Part B DME File Load
    SurgicalProcedureComboId

    NULL

    SurgicalProcedureComboIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    SurgicalProcedureComboId

    NULL

    SurgicalProcedureComboIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    SurgicalProcedureComboId

    NULL

    SurgicalProcedureComboIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    SurgicalProcedureComboId

    NULL

    SurgicalProcedureComboIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    SurgicalProcedureComboId

    NULL

    SurgicalProcedureComboIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    SurgicalProcedureComboId
    CmsCjrHospiceHeader.CLM_NUM_SK
    CmsCjrHospiceHeader.CLM_TYPE_CD

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    SurgicalProcedureComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Inpatient Claim Load
    SurgicalProcedureComboId
    CmsCjrInpatientHeader.CLM_DT_SGNTR_SK
    CmsCjrInpatientHeader.CLM_NUM_SK
    CmsCjrInpatientHeader.CLM_TYPE_CD
    CmsCjrInpatientHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    SurgicalProcedureComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Outpatient Claim Load
    SurgicalProcedureComboId

    NULL

    SurgicalProcedureComboIdType

    NotApplicable

    CMS CJR Part B Claim Load
    SurgicalProcedureComboId
    CmsCjrPartBHeader.CLM_DT_SGNTR_SK
    CmsCjrPartBHeader.CLM_NUM_SK
    CmsCjrPartBHeader.CLM_TYPE_CD
    CmsCjrPartBHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    SurgicalProcedureComboIdType

    CmsCjrUniqueClaimId

    CMS CJR Skilled Nursing Facility Claim Load
    SurgicalProcedureComboId
    CmsCjrSkilledNursingHeader.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingHeader.CLM_NUM_SK
    CmsCjrSkilledNursingHeader.CLM_TYPE_CD
    CmsCjrSkilledNursingHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    SurgicalProcedureComboIdType

    CmsCjrUniqueClaimId

    Data Aggregation Medical Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    SurgicalProcedureComboIdType

    "EpicClaimInformationId"

    Data Aggregation Pharmacy Claim Load
    SurgicalProcedureComboId
    SurgicalProcedureComboIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    SurgicalProcedureComboIdType

    "EpicClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    SurgicalProcedureComboId
    SurgicalProcedureComboIdType

    "NotApplicable"

    Payer System Medical Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    SurgicalProcedureComboIdType

    "EpicClaimInformationId"

    Payer System Pharmacy Claim Load
    SurgicalProcedureComboId
    SurgicalProcedureComboIdType

    "NotApplicable"

    Received Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    SurgicalProcedureComboIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    SurgicalProcedureComboId
    SurgicalProcedureComboIdType

    "NotApplicable"

    SurgicalProcedureComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes

    SurgicalProcedureNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes

    SurgicalProcedureComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SurgicalProcedureComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    CMS ACO Part B DME File Load
    SurgicalProcedureComboId

    NULL

    CMS ACO Part B Physicians File Load
    SurgicalProcedureComboId

    NULL

    CMS ACO Part D Prescription Drug File Load
    SurgicalProcedureComboId

    NULL

    CMS CJR DME Claim Load
    SurgicalProcedureComboId

    NULL

    CMS CJR Home Health Claim Load
    SurgicalProcedureComboId

    NULL

    CMS CJR Hospice Claim Load
    SurgicalProcedureComboId
    CmsCjrHospiceHeader.CLM_NUM_SK
    CmsCjrHospiceHeader.CLM_TYPE_CD

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Inpatient Claim Load
    SurgicalProcedureComboId
    CmsCjrInpatientHeader.CLM_DT_SGNTR_SK
    CmsCjrInpatientHeader.CLM_NUM_SK
    CmsCjrInpatientHeader.CLM_TYPE_CD
    CmsCjrInpatientHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Outpatient Claim Load
    SurgicalProcedureComboId

    NULL

    CMS CJR Part B Claim Load
    SurgicalProcedureComboId
    CmsCjrPartBHeader.CLM_DT_SGNTR_SK
    CmsCjrPartBHeader.CLM_NUM_SK
    CmsCjrPartBHeader.CLM_TYPE_CD
    CmsCjrPartBHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Skilled Nursing Facility Claim Load
    SurgicalProcedureComboId
    CmsCjrSkilledNursingHeader.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingHeader.CLM_NUM_SK
    CmsCjrSkilledNursingHeader.CLM_TYPE_CD
    CmsCjrSkilledNursingHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    Data Aggregation Medical Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    Externally Adjudicated Medical Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    Payer System Medical Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID
    Received Claim Load
    SurgicalProcedureComboId
    AP_CLAIM.CLAIM_ID

    PrimaryProcedureKey

    : integer
    Links to ProcedureDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    PrimaryProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.ICD_PX_RANK
    PrimaryProcedureIdType
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.ICD_PX_RANK

    If PRIMARYPROCEDUREID is not NULL then "EpicIcdCode" Otherwise "NotApplicable"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    PrimaryProcedureDurableKey

    : integer
    Links to ProcedureDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    CMS ACO Part B DME File Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS CJR Hospice Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    CMS CJR Inpatient Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    CMS CJR Outpatient Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Facility Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "NotApplicable"

    Data Aggregation Medical Claim Load
    PrimaryProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.ICD_PX_RANK
    PrimaryProcedureIdType
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.ICD_PX_RANK

    If PRIMARYPROCEDUREID is not NULL then "EpicIcdCode" Otherwise "NotApplicable"

    Data Aggregation Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    Payer System Medical Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    Payer System Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    Received Claim Load
    PrimaryProcedureId

    NULL

    PrimaryProcedureIdType

    "Unspecified"

    Received Pharmacy Claim Load
    PrimaryProcedureId
    PrimaryProcedureIdType

    "NotApplicable"

    FirstProcedureKey

    : integer
    Links to ProcedureDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstProcedureId
    MsspPartAProcedureCode.CLM_PRCDR_CD
    MsspPartAProcedureCode.CLM_VAL_SQNC_NUM

    CLM_PRCDR_CD where CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType
    MsspPartAProcedureCode.DGNS_PRCDR_ICD_IND
    MsspPartAProcedureCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "Unspecified"

    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    FirstProcedureId
    CmsCjrDiagnosesProcedures.CLM_PROD_TYPE_CD
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    CmsCjrDiagnosesProcedures.CODE_VALUE

    First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then "ICD-10-PCS" Otherwise "Unspecified"

    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    FirstProcedureId
    CmsCjrDiagnosesProcedures.CLM_PROD_TYPE_CD
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    CmsCjrDiagnosesProcedures.CODE_VALUE

    First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified"

    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    FirstProcedureId
    CmsCjrDiagnosesProcedures.CLM_PROD_TYPE_CD
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    CmsCjrDiagnosesProcedures.CODE_VALUE

    First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified"

    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    FirstProcedureId
    FirstProcedureIdType
    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    FirstProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.LINE

    ICD_PX_ID where LINE = 1

    FirstProcedureIdType

    "EpicIcdCode"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    FirstProcedureId
    FirstProcedureIdType
    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    FirstProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.LINE

    ICD_PX_ID where LINE = 1

    FirstProcedureIdType

    "EpicIcdCode"

    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    FirstProcedureDurableKey

    : integer
    Links to ProcedureDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstProcedureId
    MsspPartAProcedureCode.CLM_PRCDR_CD
    MsspPartAProcedureCode.CLM_VAL_SQNC_NUM

    CLM_PRCDR_CD where CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType
    MsspPartAProcedureCode.DGNS_PRCDR_ICD_IND
    MsspPartAProcedureCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "Unspecified"

    CMS ACO Part B DME File Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS CJR Hospice Claim Load
    FirstProcedureId
    CmsCjrDiagnosesProcedures.CLM_PROD_TYPE_CD
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    CmsCjrDiagnosesProcedures.CODE_VALUE

    First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then "ICD-10-PCS" Otherwise "Unspecified"

    CMS CJR Inpatient Claim Load
    FirstProcedureId
    CmsCjrDiagnosesProcedures.CLM_PROD_TYPE_CD
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    CmsCjrDiagnosesProcedures.CODE_VALUE

    First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified"

    CMS CJR Outpatient Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Load
    FirstProcedureId

    NULL

    FirstProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Facility Claim Load
    FirstProcedureId
    CmsCjrDiagnosesProcedures.CLM_PROD_TYPE_CD
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    CmsCjrDiagnosesProcedures.CODE_VALUE

    First CODE_VALUE for the claim where CLM_PROD_TYPE_CD = "S"-Procedure and CLM_VAL_SQNC_NUM = 1

    FirstProcedureIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then "ICD-9-CM" Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then "ICD-10-PCS" Otherwise "Unspecified"

    Data Aggregation Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    Externally Adjudicated Medical Claim Load
    FirstProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.LINE

    ICD_PX_ID where LINE = 1

    FirstProcedureIdType

    "EpicIcdCode"

    Externally Adjudicated Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    Payer System Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    Received Claim Load
    FirstProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    AP_CLAIM_ICD_PROC.LINE

    ICD_PX_ID where LINE = 1

    FirstProcedureIdType

    "EpicIcdCode"

    Received Pharmacy Claim Load
    FirstProcedureId
    FirstProcedureIdType

    "NotApplicable"

    ContractKey

    : integer
    Links to ContractDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    CMS CJR Home Health Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    CMS CJR Hospice Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    CMS CJR Inpatient Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    CMS CJR Outpatient Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    CMS CJR Part B Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    CMS CJR Skilled Nursing Facility Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    Externally Adjudicated Medical Claim Load
    ContractId
    AP_CLAIM.BENEFIT_PLAN_ID
    AP_CLAIM.CLM_LOB_ID
    AP_CLAIM.PLAN_GROUP_ID
    AP_CLAIM.WORKFLOW_PAYOR_ID
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID
    AP_CLAIM_PROGRAM_INFO.PROGRAM_ID
    PLAN_GRP.CORP_ID
    PLAN_GRP.DIV_ID
    PLAN_GRP_BEN_PLAN.BEN_PLAN_PAYOR_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    Externally Adjudicated Pharmacy Claim Load
    ContractId
    AP_CLM_RX_PROGRAM_INFO.PROGRAM_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    Received Claim Load
    ContractId
    AP_CLAIM_PROGRAM_INFO.PROGRAM_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    Received Pharmacy Claim Load
    ContractId
    AP_CLM_RX_PROGRAM_INFO.PROGRAM_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    ContractSourceDataKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    ContractSourceName

    NULL (use source of the package)

    CMS ACO Part B DME File Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    ContractSourceName

    NULL (use source of the package)

    CMS ACO Part B Physicians File Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    ContractSourceName

    NULL (use source of the package)

    CMS ACO Part D Prescription Drug File Load
    ContractId

    NULL

    ContractIdType

    "NotApplicable"

    ContractSourceName

    NULL (use source of the package)

    CMS CJR DME Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    CMS CJR Home Health Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    CMS CJR Hospice Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    CMS CJR Inpatient Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    CMS CJR Outpatient Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    CMS CJR Part B Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    CMS CJR Skilled Nursing Facility Claim Load
    ContractId

    1

    ContractIdType

    CmsCjrContractId

    ContractSourceName

    NULL (use source of the package)

    Externally Adjudicated Medical Claim Load
    ContractId
    AP_CLAIM.BENEFIT_PLAN_ID
    AP_CLAIM.CLM_LOB_ID
    AP_CLAIM.PLAN_GROUP_ID
    AP_CLAIM.WORKFLOW_PAYOR_ID
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID
    AP_CLAIM_PROGRAM_INFO.PROGRAM_ID
    PLAN_GRP.CORP_ID
    PLAN_GRP.DIV_ID
    PLAN_GRP_BEN_PLAN.BEN_PLAN_PAYOR_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    ContractSourceName

    NULL (use source of the package)

    Externally Adjudicated Pharmacy Claim Load
    ContractId
    AP_CLM_RX_PROGRAM_INFO.PROGRAM_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    ContractSourceName

    NULL (use source of the package)

    Received Claim Load
    ContractId
    AP_CLAIM_PROGRAM_INFO.PROGRAM_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    ContractSourceName

    NULL (use source of the package)

    Received Pharmacy Claim Load
    ContractId
    AP_CLM_RX_PROGRAM_INFO.PROGRAM_ID

    This column is populated based on the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles make use of the bridge to associate claims to contracts. Remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractIdType

    "ContractId"

    ContractSourceName

    NULL (use source of the package)

    ContractComboKey

    : integer
    Links to ContractBridge

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ContractComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    ContractComboIdType

    "MsspClaimUniqueId"

    CMS ACO Part B DME File Load
    ContractComboId
    MsspPartBDme.CUR_CLM_UNIQ_ID
    ContractComboIdType

    "MsspClaimUniqueId"

    CMS ACO Part B Physicians File Load
    ContractComboId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    ContractComboIdType

    "MsspClaimUniqueId"

    CMS ACO Part D Prescription Drug File Load
    ContractComboId
    MsspPartD.CUR_CLM_UNIQ_ID
    ContractComboIdType

    "MsspClaimUniqueId"

    CMS CJR DME Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    CMS CJR Home Health Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    CMS CJR Hospice Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    CMS CJR Inpatient Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    CMS CJR Outpatient Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    CMS CJR Part B Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    CMS CJR Skilled Nursing Facility Claim Load
    ContractComboId

    1

    ContractComboIdType

    CmsCjrContractId

    Data Aggregation Medical Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID
    ContractComboIdType

    "EpicClaimInformationId"

    Data Aggregation Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID
    ContractComboIdType
    Externally Adjudicated Medical Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractComboIdType

    "EpicClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractComboIdType

    "EpicPharmacyClaimInformationId"

    Payer System Medical Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID
    ContractComboIdType

    "EpicClaimInformationId"

    Payer System Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID
    ContractComboIdType
    Received Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractComboIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractComboIdType

    "EpicPharmacyClaimInformationId"

    ContractComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes

    ContractComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ContractComboId
    MsspPartAClaimsHeader.CUR_CLM_UNIQ_ID
    CMS ACO Part B DME File Load
    ContractComboId
    MsspPartBDme.CUR_CLM_UNIQ_ID
    CMS ACO Part B Physicians File Load
    ContractComboId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    CMS ACO Part D Prescription Drug File Load
    ContractComboId
    MsspPartD.CUR_CLM_UNIQ_ID
    CMS CJR DME Claim Load
    ContractComboId

    1

    CMS CJR Home Health Claim Load
    ContractComboId

    1

    CMS CJR Hospice Claim Load
    ContractComboId

    1

    CMS CJR Inpatient Claim Load
    ContractComboId

    1

    CMS CJR Outpatient Claim Load
    ContractComboId

    1

    CMS CJR Part B Claim Load
    ContractComboId

    1

    CMS CJR Skilled Nursing Facility Claim Load
    ContractComboId

    1

    Data Aggregation Medical Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID
    Data Aggregation Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID
    Externally Adjudicated Medical Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    Externally Adjudicated Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    Payer System Medical Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID
    Payer System Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID
    Received Claim Load
    ContractComboId
    AP_CLAIM.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Division Epic ID is specified, followed by contracts for which Managed Care Corporation Epic ID is specified, followed by contracts for which Managed Care Benefit Plan Epic ID is specified, followed by contracts for which Managed Care Line of Business Epic ID is specified, followed by contracts for which Managed Care Payor Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    Received Pharmacy Claim Load
    ContractComboId
    AP_CLM_RX.CLAIM_ID

    This column is populated based on either the contracts specified in claim record directly or the contracts configured in ContractDim Component Configuration. Claims that are associated directly to value-based program records in Chronicles will be associated with the contracts created from the value-based program records. For the configuration, the remaining claims will match to the most specific possible contract, based on the contract's configured Managed Care criteria. When evaluating contracts for matching, precedence is given to contracts for which Managed Care Employer Group Epic ID is specified, followed by contracts for which Managed Care Business Segment Epic ID is specified.

    In order to match to a contract, the claim must match to a value in all specified Managed Care criteria for that contract. If multiple values are specified for a particular Managed Care criterion, the claim need only match to one of the specified values in order to be considered a match to that criterion. Only contracts which are Enabled in Component Configuration will be evaluated for matching.

    ContractNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes

    LineOfBusinessKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    LineOfBusinessId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    CMS ACO Part B DME File Load
    LineOfBusinessId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    CMS ACO Part B Physicians File Load
    LineOfBusinessId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    CMS ACO Part D Prescription Drug File Load
    LineOfBusinessId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    CMS CJR DME Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    CMS CJR Home Health Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    CMS CJR Hospice Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    CMS CJR Inpatient Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    CMS CJR Outpatient Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    CMS CJR Part B Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    CMS CJR Skilled Nursing Facility Claim Load
    LineOfBusinessId
    LineOfBusinessIdType
    Data Aggregation Medical Claim Load
    LineOfBusinessId
    AP_CLAIM.CLM_LOB_ID
    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    Data Aggregation Pharmacy Claim Load
    LineOfBusinessId
    AP_CLM_RX_2.CLM_LOB_ID
    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    Externally Adjudicated Medical Claim Load
    LineOfBusinessId
    AP_CLAIM.CLM_LOB_ID
    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    Externally Adjudicated Pharmacy Claim Load
    LineOfBusinessId

    NULL

    LineOfBusinessIdType

    "NotApplicable"

    Payer System Medical Claim Load
    LineOfBusinessId
    AP_CLAIM.CLM_LOB_ID
    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    Payer System Pharmacy Claim Load
    LineOfBusinessId
    AP_CLM_RX_2.CLM_LOB_ID
    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    Received Claim Load
    LineOfBusinessId
    AP_CLAIM.CLM_LOB_ID
    LineOfBusinessIdType

    "EpicLineOfBusinessId"

    Received Pharmacy Claim Load
    LineOfBusinessId

    NULL

    LineOfBusinessIdType

    "NotApplicable"

    OwningBusinessSegmentKey

    : integer
    Links to DepartmentDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    CMS CJR Part B Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    OwningBusinessSegmentId

    NULL

    OwningBusinessSegmentIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    OwningBusinessSegmentId
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID

    "EpicFacilityProfileId"

    Data Aggregation Pharmacy Claim Load
    OwningBusinessSegmentId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    Externally Adjudicated Medical Claim Load
    OwningBusinessSegmentId
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    Externally Adjudicated Pharmacy Claim Load
    OwningBusinessSegmentId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    Payer System Medical Claim Load
    OwningBusinessSegmentId
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    Payer System Pharmacy Claim Load
    OwningBusinessSegmentId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    Received Claim Load
    OwningBusinessSegmentId
    AP_CLAIM_3.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    Received Pharmacy Claim Load
    OwningBusinessSegmentId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningBusinessSegmentIdType

    "EpicFacilityProfileId"

    OwningServiceAreaKey

    : integer
    Links to DepartmentDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    "NotApplicable"

    CMS ACO Part D Prescription Drug File Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    "NotApplicable"

    CMS CJR DME Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    CMS CJR Part B Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    OwningServiceAreaId

    NULL

    OwningServiceAreaIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    OwningServiceAreaId
    AP_CLAIM_2.OWN_BUS_SEG_SA_ID
    OwningServiceAreaIdType
    AP_CLAIM_2.OWN_BUS_SEG_SA_ID

    "EpicFacilityProfileId"

    Data Aggregation Pharmacy Claim Load
    OwningServiceAreaId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    Externally Adjudicated Medical Claim Load
    OwningServiceAreaId
    AP_CLAIM_2.OWN_BUS_SEG_SA_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    Externally Adjudicated Pharmacy Claim Load
    OwningServiceAreaId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    Payer System Medical Claim Load
    OwningServiceAreaId
    AP_CLAIM_2.OWN_BUS_SEG_SA_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    Payer System Pharmacy Claim Load
    OwningServiceAreaId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    Received Claim Load
    OwningServiceAreaId
    AP_CLAIM_2.OWN_BUS_SEG_SA_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    Received Pharmacy Claim Load
    OwningServiceAreaId
    AP_CLM_RX.OWN_BUSINESS_SEGMENT_POS_ID
    OwningServiceAreaIdType

    "EpicFacilityProfileId"

    ServiceAreaComboKey

    : integer
    Links to DepartmentBridge

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    ServiceAreaComboIdType

    "EpicFacilityProfileId"

    CMS ACO Part B DME File Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    ServiceAreaComboIdType

    "EpicFacilityProfileId"

    CMS ACO Part B Physicians File Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    ServiceAreaComboIdType

    "EpicFacilityProfileId"

    CMS ACO Part D Prescription Drug File Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    ServiceAreaComboIdType

    "EpicFacilityProfileId"

    CMS CJR DME Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    CMS CJR Home Health Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    CMS CJR Hospice Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    CMS CJR Inpatient Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    CMS CJR Outpatient Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    CMS CJR Part B Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceAreaComboId

    NULL

    ServiceAreaComboIdType

    NotApplicable

    Data Aggregation Medical Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    ServiceAreaComboIdType

    "EpicClaimInformationId"

    Data Aggregation Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    ServiceAreaComboIdType

    "EpicPharmacyClaimInformationId"

    Externally Adjudicated Medical Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    ServiceAreaComboIdType

    "EpicClaimInformationId"

    Externally Adjudicated Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    ServiceAreaComboIdType

    "EpicPharmacyClaimInformationId"

    Payer System Medical Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    ServiceAreaComboIdType

    "EpicClaimInformationId"

    Payer System Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    ServiceAreaComboIdType

    "EpicPharmacyClaimInformationId"

    Received Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    ServiceAreaComboIdType

    "EpicClaimInformationId"

    Received Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    ServiceAreaComboIdType

    "EpicPharmacyClaimInformationId"

    ServiceAreaComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes

    ServiceAreaNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes

    ServiceAreaComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    CMS ACO Part B DME File Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    CMS ACO Part B Physicians File Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    CMS ACO Part D Prescription Drug File Load
    ServiceAreaComboId

    Epic.ConfigurationInfo_PlanAttributeConfiguration.EligibilityBusinessSegmentDefaultId Business segment configured through interface configuration in Chronicles

    CMS CJR DME Claim Load
    ServiceAreaComboId

    NULL

    CMS CJR Home Health Claim Load
    ServiceAreaComboId

    NULL

    CMS CJR Hospice Claim Load
    ServiceAreaComboId

    NULL

    CMS CJR Inpatient Claim Load
    ServiceAreaComboId

    NULL

    CMS CJR Outpatient Claim Load
    ServiceAreaComboId

    NULL

    CMS CJR Part B Claim Load
    ServiceAreaComboId

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceAreaComboId

    NULL

    Data Aggregation Medical Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    Data Aggregation Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    Externally Adjudicated Medical Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    Externally Adjudicated Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    Payer System Medical Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    Payer System Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID
    Received Claim Load
    ServiceAreaComboId
    AP_CLAIM.CLAIM_ID
    Received Pharmacy Claim Load
    ServiceAreaComboId
    AP_CLM_RX.CLAIM_ID

    EndDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    EndDate
    MsspPartAClaimsHeader.CLM_THRU_DT

    If CLM_THRU_DT < 1/1/1753 or CLM_THRU_DT = 12/31/9999 then NULL Otherwise CLM_THRU_DT

    CMS ACO Part B DME File Load
    EndDate
    MsspPartBDme.CLM_THRU_DT

    If CLM_THRU_DT < 1/1/1753 or CLM_THRU_DT = 12/31/9999 then NULL Otherwise CLM_THRU_DT

    CMS ACO Part B Physicians File Load
    EndDate
    MsspPartBPhysicians.CLM_THRU_DT

    If CLM_THRU_DT < 1/1/1753 or CLM_THRU_DT = 12/31/9999 then NULL Otherwise CLM_THRU_DT

    CMS ACO Part D Prescription Drug File Load
    EndDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    EndDate
    CmsCjrDmeHeader.CLM_THRU_DT
    CMS CJR Home Health Claim Load
    EndDate
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CMS CJR Hospice Claim Load
    EndDate
    CmsCjrHospiceHeader.CLM_THRU_DT
    CMS CJR Inpatient Claim Load
    EndDate
    CmsCjrInpatientHeader.CLM_THRU_DT
    CMS CJR Outpatient Claim Load
    EndDate
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CMS CJR Part B Claim Load
    EndDate
    CmsCjrPartBHeader.CLM_THRU_DT
    CMS CJR Skilled Nursing Facility Claim Load
    EndDate
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    Data Aggregation Medical Claim Load
    EndDate
    AP_CLAIM.SERVICE_END_DATE
    AP_CLAIM.STMT_COV_TO_DATE

    Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    EndDate
    AP_CLM_RX.SERVICE_END_DATE
    Externally Adjudicated Medical Claim Load
    EndDate
    AP_CLAIM.SERVICE_END_DATE
    AP_CLAIM.STMT_COV_TO_DATE

    Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    EndDate
    AP_CLM_RX.SERVICE_END_DATE
    Payer System Medical Claim Load
    EndDate
    AP_CLAIM.SERVICE_END_DATE
    AP_CLAIM.STMT_COV_TO_DATE

    Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    EndDate
    AP_CLM_RX.SERVICE_END_DATE
    Received Claim Load
    EndDate
    AP_CLAIM.SERVICE_END_DATE
    AP_CLAIM.STMT_COV_TO_DATE

    Minimum of STMT_COV_TO_DATE - Time Zone: Unspecified and SERVICE_END_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    EndDate
    AP_CLM_RX.SERVICE_END_DATE

    AdmissionDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionInstant
    MsspPartAClaimsBEAndDemoCodes.CLM_ACTV_CARE_FROM_DT
    CMS ACO Part B DME File Load
    AdmissionInstant

    NULL

    CMS ACO Part B Physicians File Load
    AdmissionInstant

    NULL

    CMS ACO Part D Prescription Drug File Load
    AdmissionInstant

    NULL

    CMS CJR DME Claim Load
    AdmissionInstant

    NULL

    CMS CJR Home Health Claim Load
    AdmissionInstant

    NULL

    CMS CJR Hospice Claim Load
    AdmissionInstant

    NULL

    CMS CJR Inpatient Claim Load
    AdmissionInstant
    CmsCjrInpatientHeader.ADMSN_DT
    CMS CJR Outpatient Claim Load
    AdmissionInstant

    NULL

    CMS CJR Part B Claim Load
    AdmissionInstant

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    AdmissionInstant
    CmsCjrSkilledNursingHeader.ADMSN_DT
    Data Aggregation Medical Claim Load
    AdmissionInstant
    AP_CLAIM.ADMISSION_DATE
    Externally Adjudicated Medical Claim Load
    AdmissionInstant
    AP_CLAIM.ADMISSION_DATE
    Payer System Medical Claim Load
    AdmissionInstant
    AP_CLAIM.ADMISSION_DATE
    Received Claim Load
    AdmissionInstant
    AP_CLAIM.ADMISSION_DATE

    DischargeDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DischargeInstant

    NULL

    CMS ACO Part B DME File Load
    DischargeInstant

    NULL

    CMS ACO Part B Physicians File Load
    DischargeInstant

    NULL

    CMS ACO Part D Prescription Drug File Load
    DischargeInstant

    NULL

    CMS CJR DME Claim Load
    DischargeInstant

    NULL

    CMS CJR Home Health Claim Load
    DischargeInstant

    NULL

    CMS CJR Hospice Claim Load
    DischargeInstant

    NULL

    CMS CJR Inpatient Claim Load
    DischargeInstant
    CmsCjrInpatientHeader.DSCHRGDT
    CMS CJR Outpatient Claim Load
    DischargeInstant

    NULL

    CMS CJR Part B Claim Load
    DischargeInstant

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    DischargeInstant
    CmsCjrSkilledNursingHeader.DSCHRGDT
    Data Aggregation Medical Claim Load
    DischargeInstant
    AP_CLAIM.DISCHARGE_DATE
    Externally Adjudicated Medical Claim Load
    DischargeInstant
    AP_CLAIM.DISCHARGE_DATE
    Payer System Medical Claim Load
    DischargeInstant
    AP_CLAIM.DISCHARGE_DATE
    Received Claim Load
    DischargeInstant
    AP_CLAIM.DISCHARGE_DATE
    AP_CLAIM.STMT_COV_TO_DATE
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_OCCR_CODE.EXTERNAL_OCCUR_CODE
    AP_CLAIM_OCCR_CODE.OCCUR_DATE

    If DISCHARGE_DATE is not NULL then DISCHARGE_DATE Otherwise if there is at least one OCCUR_DATE where EXTERNAL_OCCUR_CODE = 42 then maximum of OCCUR_DATE where EXTERNAL_OCCUR_CODE = 42 Otherwise if there is at least one OCCUR_DATE where EXTERNAL_OCCUR_CODE = 36, 37, or 39 then maximum of OCCUR_DATE where EXTERNAL_OCCUR_CODE = 36, 37, or 39 Otherwise if TYPE_OF_BILL is not 3 or 4 digits or the last digit of TYPE_OF_BILL � 1 or 4 then NULL Otherwise if TYPE_OF_BILL is of format 011X, 018X, 021X, 028X, 041X, 065X, 066X, 084X, 086X, or 089X (leading 0 is optional) then STMT_COV_TO_DATE

    ClaimReceivedDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ClaimReceivedDate

    12/31/9999

    CMS ACO Part B DME File Load
    ClaimReceivedDate

    12/31/9999

    CMS ACO Part B Physicians File Load
    ClaimReceivedDate

    12/31/9999

    CMS ACO Part D Prescription Drug File Load
    ClaimReceivedDate

    12/31/9999

    CMS CJR DME Claim Load
    ClaimReceivedDate

    NULL

    CMS CJR Home Health Claim Load
    ClaimReceivedDate

    NULL

    CMS CJR Hospice Claim Load
    ClaimReceivedDate

    NULL

    CMS CJR Inpatient Claim Load
    ClaimReceivedDate

    NULL

    CMS CJR Outpatient Claim Load
    ClaimReceivedDate

    NULL

    CMS CJR Part B Claim Load
    ClaimReceivedDate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ClaimReceivedDate

    NULL

    Data Aggregation Medical Claim Load
    ClaimReceivedDate
    AP_CLAIM.DATE_RECEIVED
    Data Aggregation Pharmacy Claim Load
    ClaimReceivedDate
    AP_CLM_RX.RECEIVED_DATE
    Externally Adjudicated Medical Claim Load
    ClaimReceivedDate
    AP_CLAIM.DATE_RECEIVED
    Externally Adjudicated Pharmacy Claim Load
    ClaimReceivedDate
    AP_CLM_RX.RECEIVED_DATE
    Payer System Medical Claim Load
    ClaimReceivedDate
    AP_CLAIM.DATE_RECEIVED
    Payer System Pharmacy Claim Load
    ClaimReceivedDate
    AP_CLM_RX.RECEIVED_DATE
    Received Claim Load
    ClaimReceivedDate
    AP_CLAIM.DATE_RECEIVED

    Time Zone: Unspecified

    Received Pharmacy Claim Load
    ClaimReceivedDate
    AP_CLM_RX.RECEIVED_DATE

    CreatedDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CreatedDate

    NULL

    CMS ACO Part B DME File Load
    CreatedDate

    NULL

    CMS ACO Part B Physicians File Load
    CreatedDate

    NULL

    CMS ACO Part D Prescription Drug File Load
    CreatedDate

    NULL

    CMS CJR DME Claim Load
    CreatedDate

    NULL

    CMS CJR Home Health Claim Load
    CreatedDate

    NULL

    CMS CJR Hospice Claim Load
    CreatedDate

    NULL

    CMS CJR Inpatient Claim Load
    CreatedDate

    NULL

    CMS CJR Outpatient Claim Load
    CreatedDate

    NULL

    CMS CJR Part B Claim Load
    CreatedDate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    CreatedDate

    NULL

    Received Claim Load
    CreatedDate
    AP_CLAIM.ENTRY_DATE

    CleanDeniedDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CleanDeniedDate

    NULL

    CMS ACO Part B DME File Load
    CleanDeniedDate

    NULL

    CMS ACO Part B Physicians File Load
    CleanDeniedDate

    NULL

    CMS ACO Part D Prescription Drug File Load
    CleanDeniedDate

    NULL

    CMS CJR DME Claim Load
    CleanDeniedDate

    NULL

    CMS CJR Home Health Claim Load
    CleanDeniedDate

    NULL

    CMS CJR Hospice Claim Load
    CleanDeniedDate

    NULL

    CMS CJR Inpatient Claim Load
    CleanDeniedDate

    NULL

    CMS CJR Outpatient Claim Load
    CleanDeniedDate

    NULL

    CMS CJR Part B Claim Load
    CleanDeniedDate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    CleanDeniedDate

    NULL

    Received Claim Load
    CleanDeniedDate
    AP_CLAIM.STATUS_C
    AP_CLAIM.STATUS_DATE

    If AP_CLAIM.STATUS_C is 3-Clean or 4-Denied then AP_CLAIM.STATUS_DATE Otherwise NULL

    InitialPaidInApDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    InitialPaidInApDate
    CMS ACO Part B DME File Load
    InitialPaidInApDate
    CMS ACO Part B Physicians File Load
    InitialPaidInApDate
    CMS ACO Part D Prescription Drug File Load
    InitialPaidInApDate
    CMS CJR DME Claim Load
    InitialPaidInApDate
    CMS CJR Home Health Claim Load
    InitialPaidInApDate
    CMS CJR Hospice Claim Load
    InitialPaidInApDate
    CMS CJR Inpatient Claim Load
    InitialPaidInApDate
    CMS CJR Outpatient Claim Load
    InitialPaidInApDate
    CMS CJR Part B Claim Load
    InitialPaidInApDate
    CMS CJR Skilled Nursing Facility Claim Load
    InitialPaidInApDate
    Data Aggregation Medical Claim Load
    InitialPaidInApDate
    Data Aggregation Pharmacy Claim Load
    InitialPaidInApDate
    Externally Adjudicated Medical Claim Load
    InitialPaidInApDate
    Externally Adjudicated Pharmacy Claim Load
    InitialPaidInApDate
    Payer System Medical Claim Load
    InitialPaidInApDate
    Payer System Pharmacy Claim Load
    InitialPaidInApDate
    Received Claim Load
    InitialPaidInApDate
    AP_CHECK.POST_DATE
    AP_CHECK.VOIDED_DATE
    AP_CLAIM_2.PAID_CHECK_ID
    AP_CLAIM_VOIDED_CHECK.AP_STS_C

    If there exist any checks where AP_CLAIM_VOIDED_CHECK.AP_STS_C = 3-EOB Generated then the maximum of AP_CHECK.POST_DATE that is no later than the minimum of AP_CHECK.VOIDED_DATE of that set Otherwise AP_CHECK.POST_DATE for AP_CLAIM_2.PAID_CHECK_ID

    Received Pharmacy Claim Load
    InitialPaidInApDate

    PaidDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PaidDate

    MsspPartAClaimsHeader.CLM_EFCTV_DT

    CMS ACO Part B DME File Load
    PaidDate

    MsspPartBDme.CLM_EFCTV_DT

    CMS ACO Part B Physicians File Load
    PaidDate

    MsspPartBPhysicians.CLM_EFCTV_DT

    CMS ACO Part D Prescription Drug File Load
    PaidDate

    MsspPartD.CLM_EFCTV_DT

    CMS CJR DME Claim Load
    PaidDate

    NULL

    CMS CJR Home Health Claim Load
    PaidDate

    NULL

    CMS CJR Hospice Claim Load
    PaidDate

    NULL

    CMS CJR Inpatient Claim Load
    PaidDate

    NULL

    CMS CJR Outpatient Claim Load
    PaidDate

    NULL

    CMS CJR Part B Claim Load
    PaidDate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    PaidDate

    NULL

    Data Aggregation Medical Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT

    Data Aggregation Pharmacy Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Externally Adjudicated Medical Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Externally Adjudicated Pharmacy Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Payer System Medical Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT

    Payer System Pharmacy Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Received Claim Load
    PaidDate
    AP_CHECK.CHECK_ID
    AP_CHECK.POST_DATE
    AP_CLAIM_2.PAID_CHECK_ID
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    If POST_DATE is not null then POST_DATE Otherwise OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Received Pharmacy Claim Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTH_PAY_INFO_VAL_DT where OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    PaymentDueDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PaymentDueDate

    NULL

    CMS ACO Part B DME File Load
    PaymentDueDate

    NULL

    CMS ACO Part B Physicians File Load
    PaymentDueDate

    NULL

    CMS ACO Part D Prescription Drug File Load
    PaymentDueDate

    NULL

    CMS CJR DME Claim Load
    PaymentDueDate

    NULL

    CMS CJR Home Health Claim Load
    PaymentDueDate

    NULL

    CMS CJR Hospice Claim Load
    PaymentDueDate

    NULL

    CMS CJR Inpatient Claim Load
    PaymentDueDate

    NULL

    CMS CJR Outpatient Claim Load
    PaymentDueDate

    NULL

    CMS CJR Part B Claim Load
    PaymentDueDate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    PaymentDueDate

    NULL

    Received Claim Load
    PaymentDueDate
    AP_CLAIM.PAY_BY_DATE
    AP_CLAIM_MILESTONES.TARGET_DATE

    If TARGET_DATE is not null then TARGET_DATE Otherwise PAY_BY_DATE

    IsValidInSequenceThroughDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3

    AdjustmentType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS ACO Part B DME File Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBDme.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS ACO Part B Physicians File Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS ACO Part D Prescription Drug File Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartD.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS CJR DME Claim Load
    AdjustmentType

    *Not Applicable

    CMS CJR Home Health Claim Load
    AdjustmentType

    *Not Applicable

    CMS CJR Hospice Claim Load
    AdjustmentType

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AdjustmentType

    *Not Applicable

    CMS CJR Outpatient Claim Load
    AdjustmentType

    *Not Applicable

    CMS CJR Part B Claim Load
    AdjustmentType

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdjustmentType

    *Not Applicable

    Data Aggregation Medical Claim Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID
    AP_CLAIM_3.LOOP_OR_SPLIT_YN

    If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Data Aggregation Pharmacy Claim Load
    AdjustmentType
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    AP_CLM_RX_2.LOOP_OR_SPLIT_YN
    CLM_VALUES.BILL_TYP_FREQ_CD

    If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Externally Adjudicated Medical Claim Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original"

    Externally Adjudicated Pharmacy Claim Load
    AdjustmentType
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID

    If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Payer System Medical Claim Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID
    AP_CLAIM_3.LOOP_OR_SPLIT_YN

    If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Payer System Pharmacy Claim Load
    AdjustmentType
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    AP_CLM_RX_2.LOOP_OR_SPLIT_YN
    CLM_VALUES.BILL_TYP_FREQ_CD

    If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Received Claim Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original"

    Received Pharmacy Claim Load
    AdjustmentType
    AP_CLM_RX.ORIG_OF_ADJUST_CLAIM_ID
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID

    If ORIG_OF_REV_CLAIM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    AdmissionTypeCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionTypeCode
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD
    CMS ACO Part B DME File Load
    AdmissionTypeCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionTypeCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AdmissionTypeCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AdmissionTypeCode
    CmsCjrInpatientHeader.TYPE_ADM
    CMS CJR Outpatient Claim Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Part B Claim Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdmissionTypeCode
    CmsCjrSkilledNursingHeader.TYPE_ADM
    Data Aggregation Medical Claim Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Data Aggregation Pharmacy Claim Load
    AdmissionTypeCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Externally Adjudicated Pharmacy Claim Load
    AdmissionTypeCode

    "*Not Applicable"

    Payer System Medical Claim Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Payer System Pharmacy Claim Load
    AdmissionTypeCode

    "*Not Applicable"

    Received Claim Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Received Pharmacy Claim Load
    AdmissionTypeCode

    "*Not Applicable"

    AdmissionType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    If CLM_ADMSN_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdmissionTypeCode"

    CMS ACO Part B DME File Load
    AdmissionType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionType

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AdmissionType

    "*Not Applicable"

    CMS CJR DME Claim Load
    AdmissionType

    *Not Applicable

    CMS CJR Home Health Claim Load
    AdmissionType

    *Not Applicable

    CMS CJR Hospice Claim Load
    AdmissionType

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.TYPE_ADM

    If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode

    CMS CJR Outpatient Claim Load
    AdmissionType

    *Not Applicable

    CMS CJR Part B Claim Load
    AdmissionType

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode

    Data Aggregation Medical Claim Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Data Aggregation Pharmacy Claim Load
    AdmissionType

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Externally Adjudicated Pharmacy Claim Load
    AdmissionType

    "*Not Applicable"

    Payer System Medical Claim Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Payer System Pharmacy Claim Load
    AdmissionType

    "*Not Applicable"

    Received Claim Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Received Pharmacy Claim Load
    AdmissionType

    "*Not Applicable"

    AdmissionSourceCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionSourceCode
    MsspPartAClaimsHeader.CLM_ADMSN_SRC_CD
    CMS ACO Part B DME File Load
    AdmissionSourceCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionSourceCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AdmissionSourceCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AdmissionSourceCode
    CmsCjrInpatientHeader.SRC_ADMS
    CMS CJR Outpatient Claim Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Part B Claim Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdmissionSourceCode
    CmsCjrSkilledNursingHeader.SRC_ADMS
    Data Aggregation Medical Claim Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Data Aggregation Pharmacy Claim Load
    AdmissionSourceCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Externally Adjudicated Pharmacy Claim Load
    AdmissionSourceCode

    "*Not Applicable"

    Payer System Medical Claim Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Payer System Pharmacy Claim Load
    AdmissionSourceCode

    "*Not Applicable"

    Received Claim Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Received Pharmacy Claim Load
    AdmissionSourceCode

    "*Not Applicable"

    AdmissionSource

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADMSN_SRC_CD
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    If CLM_ADMSN_SRC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CLM_ADMSN_TYPE_CD = 4-Newborn and CategoryName = "ClaimAdmissionSourceCodeNewborn" then "*Unknown" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionSourceCode" then "*Unknown" Otherwise if CLM_ADMSN_TYPE_CD = 4-Newborn then Name where CategoryName = "ClaimAdmissionSourceCodeNewborn" Otherwise Name where CategoryName = "ClaimAdmissionSourceCode"

    CMS ACO Part B DME File Load
    AdmissionSource

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionSource

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AdmissionSource

    "*Not Applicable"

    CMS CJR DME Claim Load
    AdmissionSource

    *Not Applicable

    CMS CJR Home Health Claim Load
    AdmissionSource

    *Not Applicable

    CMS CJR Hospice Claim Load
    AdmissionSource

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.SRC_ADMS
    CmsCjrInpatientHeader.TYPE_ADM

    If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode

    CMS CJR Outpatient Claim Load
    AdmissionSource

    *Not Applicable

    CMS CJR Part B Claim Load
    AdmissionSource

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.SRC_ADMS
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode

    Data Aggregation Medical Claim Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Data Aggregation Pharmacy Claim Load
    AdmissionSource

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Externally Adjudicated Pharmacy Claim Load
    AdmissionSource

    "*Not Applicable"

    Payer System Medical Claim Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Payer System Pharmacy Claim Load
    AdmissionSource

    "*Not Applicable"

    Received Claim Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Received Pharmacy Claim Load
    AdmissionSource

    "*Not Applicable"

    DrgType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information

    CMS ACO Part B DME File Load
    DrgType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DrgType

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    DrgType

    "*Not Applicable"

    CMS CJR DME Claim Load
    DrgType

    *Not Applicable

    CMS CJR Home Health Claim Load
    DrgType

    *Not Applicable

    CMS CJR Hospice Claim Load
    DrgType

    *Not Applicable

    CMS CJR Inpatient Claim Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS CJR Outpatient Claim Load
    DrgType

    *Not Applicable

    CMS CJR Part B Claim Load
    DrgType

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information.

    Data Aggregation Medical Claim Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Data Aggregation Pharmacy Claim Load
    DrgType

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    DrgType

    "*Not Applicable"

    Payer System Medical Claim Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Payer System Pharmacy Claim Load
    DrgType

    "*Not Applicable"

    Received Claim Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Received Pharmacy Claim Load
    DrgType

    "*Not Applicable"

    DrgCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DrgCode
    MsspPartAClaimsHeader.DGNS_DRG_CD
    CMS ACO Part B DME File Load
    DrgCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DrgCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    DrgCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    DrgCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    DrgCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    DrgCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    DrgCode
    CmsCjrInpatientHeader.DRG_CD
    CMS CJR Outpatient Claim Load
    DrgCode

    *Not Applicable

    CMS CJR Part B Claim Load
    DrgCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    DrgCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Data Aggregation Pharmacy Claim Load
    DrgCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Externally Adjudicated Pharmacy Claim Load
    DrgCode

    "*Not Applicable"

    Payer System Medical Claim Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Payer System Pharmacy Claim Load
    DrgCode

    "*Not Applicable"

    Received Claim Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Received Pharmacy Claim Load
    DrgCode

    "*Not Applicable"

    SeverityOfIllness

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SeverityOfIllness
    CMS ACO Part B DME File Load
    SeverityOfIllness
    CMS ACO Part B Physicians File Load
    SeverityOfIllness
    CMS ACO Part D Prescription Drug File Load
    SeverityOfIllness
    CMS CJR DME Claim Load
    SeverityOfIllness
    CMS CJR Home Health Claim Load
    SeverityOfIllness
    CMS CJR Hospice Claim Load
    SeverityOfIllness
    CMS CJR Inpatient Claim Load
    SeverityOfIllness
    CMS CJR Outpatient Claim Load
    SeverityOfIllness
    CMS CJR Part B Claim Load
    SeverityOfIllness
    CMS CJR Skilled Nursing Facility Claim Load
    SeverityOfIllness
    Data Aggregation Medical Claim Load
    SeverityOfIllness
    CLM_VALUES_4.DRG_SOI
    Data Aggregation Pharmacy Claim Load
    SeverityOfIllness
    Externally Adjudicated Medical Claim Load
    SeverityOfIllness
    Externally Adjudicated Pharmacy Claim Load
    SeverityOfIllness
    Received Claim Load
    SeverityOfIllness
    Received Pharmacy Claim Load
    SeverityOfIllness

    RiskOfMortality

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RiskOfMortality
    CMS ACO Part B DME File Load
    RiskOfMortality
    CMS ACO Part B Physicians File Load
    RiskOfMortality
    CMS ACO Part D Prescription Drug File Load
    RiskOfMortality
    CMS CJR DME Claim Load
    RiskOfMortality
    CMS CJR Home Health Claim Load
    RiskOfMortality
    CMS CJR Hospice Claim Load
    RiskOfMortality
    CMS CJR Inpatient Claim Load
    RiskOfMortality
    CMS CJR Outpatient Claim Load
    RiskOfMortality
    CMS CJR Part B Claim Load
    RiskOfMortality
    CMS CJR Skilled Nursing Facility Claim Load
    RiskOfMortality
    Data Aggregation Medical Claim Load
    RiskOfMortality
    CLM_VALUES_4.DRG_ROM
    Data Aggregation Pharmacy Claim Load
    RiskOfMortality
    Externally Adjudicated Medical Claim Load
    RiskOfMortality
    Externally Adjudicated Pharmacy Claim Load
    RiskOfMortality
    Received Claim Load
    RiskOfMortality
    Received Pharmacy Claim Load
    RiskOfMortality

    DischargeDispositionCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DischargeDispositionCode
    MsspPartAClaimsHeader.BENE_PTNT_STUS_CD
    CMS ACO Part B DME File Load
    DischargeDispositionCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DischargeDispositionCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    DischargeDispositionCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    DischargeDispositionCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    DischargeDispositionCode
    CmsCjrHomeHealthHeader.STUS_CD
    CMS CJR Hospice Claim Load
    DischargeDispositionCode
    CmsCjrHospiceHeader.STUS_CD
    CMS CJR Inpatient Claim Load
    DischargeDispositionCode
    CmsCjrInpatientHeader.STUS_CD
    CMS CJR Outpatient Claim Load
    DischargeDispositionCode
    CmsCjrOutpatientHeader.STUS_CD
    CMS CJR Part B Claim Load
    DischargeDispositionCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    DischargeDispositionCode
    CmsCjrSkilledNursingHeader.STUS_CD
    Data Aggregation Medical Claim Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Data Aggregation Pharmacy Claim Load
    DischargeDispositionCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Externally Adjudicated Pharmacy Claim Load
    DischargeDispositionCode

    "*Not Applicable"

    Payer System Medical Claim Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Payer System Pharmacy Claim Load
    DischargeDispositionCode

    "*Not Applicable"

    Received Claim Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Received Pharmacy Claim Load
    DischargeDispositionCode

    "*Not Applicable"

    DischargeDisposition

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DischargeDisposition
    CmsCategoryList.BeneficiaryPatientStatusCode
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.BENE_PTNT_STUS_CD

    If BENE_PTNT_STUS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "BeneficiaryPatientStatusCode" then "*Unknown" Otherwise Name where CategoryName = "BeneficiaryPatientStatusCode"

    CMS ACO Part B DME File Load
    DischargeDisposition

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DischargeDisposition

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    DischargeDisposition

    "*Not Applicable"

    CMS CJR DME Claim Load
    DischargeDisposition

    *Not Applicable

    CMS CJR Home Health Claim Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrHomeHealthHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name

    CMS CJR Hospice Claim Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrHospiceHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name

    CMS CJR Inpatient Claim Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode

    CMS CJR Outpatient Claim Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrOutpatientHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode

    CMS CJR Part B Claim Load
    DischargeDisposition

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode

    Data Aggregation Medical Claim Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C
    Data Aggregation Pharmacy Claim Load
    DischargeDisposition

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME

    Externally Adjudicated Pharmacy Claim Load
    DischargeDisposition

    "*Not Applicable"

    Payer System Medical Claim Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME

    Payer System Pharmacy Claim Load
    DischargeDisposition

    "*Not Applicable"

    Received Claim Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME

    Received Pharmacy Claim Load
    DischargeDisposition

    "*Not Applicable"

    DenialReason

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DenialReason
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    CmsDenialTypeCodes.Name
    MsspPartAClaimsHeader.CLM_MDCR_NPMT_RSN_CD

    If CLM_MDCR_NPMT_RSN_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimMedicareNonPaymentReasonCode"

    CMS ACO Part B DME File Load
    DenialReason
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    CmsDenialTypeCodes.Name
    MsspPartBDme.CLM_CARR_PMT_DNL_CD

    If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimCarrierPaymentDenialCode"

    CMS ACO Part B Physicians File Load
    DenialReason
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    CmsDenialTypeCodes.Name
    MsspPartBPhysicians.CLM_CARR_PMT_DNL_CD

    If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimCarrierPaymentDenialCode"

    CMS ACO Part D Prescription Drug File Load
    DenialReason

    "*Not Applicable"

    CMS CJR DME Claim Load
    DenialReason

    *Not Applicable

    CMS CJR Home Health Claim Load
    DenialReason

    *Not Applicable

    CMS CJR Hospice Claim Load
    DenialReason

    *Not Applicable

    CMS CJR Inpatient Claim Load
    DenialReason

    *Not Applicable

    CMS CJR Outpatient Claim Load
    DenialReason

    *Not Applicable

    CMS CJR Part B Claim Load
    DenialReason

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    DenialReason

    *Not Applicable

    Data Aggregation Medical Claim Load
    DenialReason
    AP_CLAIM.STATUS_C
    CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC

    IF NON_PAYMENT_RSN_CD IS NOT NULL AND NON_PAYMENT_RSN_DESC IS NULL THEN "*Unknown" Otherwise IF CARRIER_PAYMENT_DNL_CD IS NOT NULL AND CARRIER PAYMENT_DNL_DESC IS NULL THEN "*Unknown" Otherwise IF NON_PAYMENT_RSN_DESC IS NOT NULL THEN NON_PAYMENT_RSN_DESC Otherwise IF PAYMENT_DNL_DESC IS NOT NULL THEN PAYMENT_DNL_DESC Otherwise IF STATUS_C = 3 THEN "Denied" Otherwise "*Not Applicable"

    Data Aggregation Pharmacy Claim Load
    DenialReason
    AP_CLM_RX.CLM_STATUS_C
    Externally Adjudicated Medical Claim Load
    DenialReason
    AP_CLAIM.STATUS_C
    CLM_VALUES_5.CARRIER_PAYMENT_DNL_CD
    CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC
    CLM_VALUES_5.NON_PAYMENT_RSN_CD
    CLM_VALUES_5.NON_PAYMENT_RSN_DESC

    If STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    DenialReason
    AP_CLM_RX.CLM_STATUS_C

    If CLM_STATUS_C = 3 then "Denied" Otherwise "*Not Applicable"

    Payer System Medical Claim Load
    DenialReason
    AP_CLAIM.STATUS_C
    CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC

    IF NON_PAYMENT_RSN_CD IS NOT NULL AND NON_PAYMENT_RSN_DESC IS NULL THEN "*Unknown" Otherwise IF CARRIER_PAYMENT_DNL_CD IS NOT NULL AND CARRIER PAYMENT_DNL_DESC IS NULL THEN "*Unknown" Otherwise IF NON_PAYMENT_RSN_DESC IS NOT NULL THEN NON_PAYMENT_RSN_DESC Otherwise IF PAYMENT_DNL_DESC IS NOT NULL THEN PAYMENT_DNL_DESC Otherwise IF STATUS_C = 3 THEN "Denied" Otherwise "*Not Applicable"

    Payer System Pharmacy Claim Load
    DenialReason
    AP_CLM_RX.CLM_STATUS_C
    Received Claim Load
    DenialReason
    AP_CLAIM.STATUS_C

    If STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable"

    Received Pharmacy Claim Load
    DenialReason
    AP_CLM_RX.CLM_STATUS_C

    If CLM_STATUS_C = 3 then "Denied" Otherwise "*Not Applicable"

    StartDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    StartDate
    MsspPartAClaimsHeader.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B DME File Load
    StartDate
    MsspPartBDme.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part B Physicians File Load
    StartDate
    MsspPartBPhysicians.CLM_FROM_DT

    If CLM_FROM_DT < 1/1/1753 or CLM_FROM_DT = 12/31/9999 then NULL Otherwise CLM_FROM_DT

    CMS ACO Part D Prescription Drug File Load
    StartDate
    MsspPartD.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Load
    StartDate
    CmsCjrDmeHeader.CLM_FROM_DT
    CMS CJR Home Health Claim Load
    StartDate
    CmsCjrHomeHealthHeader.CLM_FROM_DT
    CMS CJR Hospice Claim Load
    StartDate
    CmsCjrHospiceHeader.CLM_FROM_DT
    CMS CJR Inpatient Claim Load
    StartDate
    CmsCjrInpatientHeader.CLM_FROM_DT
    CMS CJR Outpatient Claim Load
    StartDate
    CmsCjrOutpatientHeader.CLM_FROM_DT
    CMS CJR Part B Claim Load
    StartDate
    CmsCjrPartBHeader.CLM_FROM_DT
    CMS CJR Skilled Nursing Facility Claim Load
    StartDate
    CmsCjrSkilledNursingHeader.CLM_FROM_DT
    Data Aggregation Medical Claim Load
    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Data Aggregation Pharmacy Claim Load
    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Externally Adjudicated Medical Claim Load
    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Externally Adjudicated Pharmacy Claim Load
    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Payer System Medical Claim Load
    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Payer System Pharmacy Claim Load
    StartDate
    AP_CLM_RX.SERVICE_START_DATE
    Received Claim Load
    StartDate
    AP_CLAIM.SERVICE_START_DATE
    AP_CLAIM.STMT_COV_FROM_DATE

    Minimum of STMT_COV_FROM_DATE - Time Zone: Unspecified and SERVICE_START_DATE - Time Zone: Unspecified

    Received Pharmacy Claim Load
    StartDate
    AP_CLM_RX.SERVICE_START_DATE

    FormType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FormType

    "institutional"

    CMS ACO Part B DME File Load
    FormType

    "professional"

    CMS ACO Part B Physicians File Load
    FormType

    "professional"

    CMS ACO Part D Prescription Drug File Load
    FormType

    "pharmacy"

    CMS CJR DME Claim Load
    FormType

    professional

    CMS CJR Home Health Claim Load
    FormType

    institutional

    CMS CJR Hospice Claim Load
    FormType

    institutional

    CMS CJR Inpatient Claim Load
    FormType

    institutional

    CMS CJR Outpatient Claim Load
    FormType

    professional

    CMS CJR Part B Claim Load
    FormType

    professional

    CMS CJR Skilled Nursing Facility Claim Load
    FormType

    institutional

    Data Aggregation Medical Claim Load
    FormType
    AP_CLAIM.CLAIM_FORMAT_C

    If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown"

    Data Aggregation Pharmacy Claim Load
    FormType

    "pharmacy"

    Externally Adjudicated Medical Claim Load
    FormType
    AP_CLAIM.CLAIM_FORMAT_C

    If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown"

    Externally Adjudicated Pharmacy Claim Load
    FormType

    "pharmacy"

    Payer System Medical Claim Load
    FormType
    AP_CLAIM.CLAIM_FORMAT_C

    If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown"

    Payer System Pharmacy Claim Load
    FormType

    "pharmacy"

    Received Claim Load
    FormType
    AP_CLAIM.CLAIM_FORMAT_C

    If CLAIM_FORMAT_C = 1 - CMS then "professional" Otherwise if CLAIM_FORMAT_C = 2 - UB then "institutional" Otherwise "*Unknown"

    Received Pharmacy Claim Load
    FormType

    "pharmacy"

    HospitalOutpatientServiceType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    HospitalOutpatientServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_OP_SRVC_TYPE_CD

    If CLM_OP_SRVC_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimOutpatientServiceTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimOutpatientServiceTypeCode"

    CMS ACO Part B DME File Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    CMS CJR DME Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    CMS CJR Home Health Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    CMS CJR Hospice Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    CMS CJR Inpatient Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    CMS CJR Outpatient Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    CMS CJR Part B Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    HospitalOutpatientServiceType

    *Not Applicable

    Data Aggregation Medical Claim Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    Payer System Medical Claim Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    Received Claim Load
    HospitalOutpatientServiceType

    "*Not Applicable"

    InterpretedClaimType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    InterpretedClaimType

    NULL

    CMS ACO Part B DME File Load
    InterpretedClaimType

    NULL

    CMS ACO Part B Physicians File Load
    InterpretedClaimType

    NULL

    CMS ACO Part D Prescription Drug File Load
    InterpretedClaimType

    NULL

    CMS CJR DME Claim Load
    InterpretedClaimType

    NULL

    CMS CJR Home Health Claim Load
    InterpretedClaimType

    Home Health

    CMS CJR Hospice Claim Load
    InterpretedClaimType

    Hospice

    CMS CJR Inpatient Claim Load
    InterpretedClaimType
    CmsCjrInpatientHeader.FAC_TYPE

    If FAC_TYPE = 1-Hospital then Hospital Inpatient Otherwise Other Inpatient

    CMS CJR Outpatient Claim Load
    InterpretedClaimType

    NULL

    CMS CJR Part B Claim Load
    InterpretedClaimType

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    InterpretedClaimType

    Skilled Nursing Facility

    Data Aggregation Medical Claim Load
    InterpretedClaimType

    NULL

    Data Aggregation Pharmacy Claim Load
    InterpretedClaimType

    NULL

    Externally Adjudicated Medical Claim Load
    InterpretedClaimType

    NULL

    Externally Adjudicated Pharmacy Claim Load
    InterpretedClaimType

    NULL

    Payer System Medical Claim Load
    InterpretedClaimType

    NULL

    Payer System Pharmacy Claim Load
    InterpretedClaimType

    NULL

    Received Claim Load
    InterpretedClaimType

    NULL

    Received Pharmacy Claim Load
    InterpretedClaimType

    NULL

    ReceivedClaimType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode"

    CMS ACO Part B DME File Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBDme.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode"

    CMS ACO Part B Physicians File Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode"

    CMS ACO Part D Prescription Drug File Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartD.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimTypeCode"

    CMS CJR DME Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrDmeHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    CMS CJR Home Health Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrHomeHealthHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    CMS CJR Hospice Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrHospiceHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    CMS CJR Inpatient Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    CMS CJR Outpatient Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrOutpatientHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    CMS CJR Part B Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrPartBHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    CMS CJR Skilled Nursing Facility Claim Load
    ReceivedClaimType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.CLM_TYPE_CD

    If CLM_TYPE_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimTypeCode then *Unknown Otherwise Name where CategoryName = ClaimTypeCode

    Data Aggregation Medical Claim Load
    ReceivedClaimType

    "Medical"

    Data Aggregation Pharmacy Claim Load
    ReceivedClaimType

    "Pharmacy"

    Externally Adjudicated Medical Claim Load
    ReceivedClaimType

    "Medical"

    Externally Adjudicated Pharmacy Claim Load
    ReceivedClaimType

    "Pharmacy"

    Payer System Medical Claim Load
    ReceivedClaimType

    "Medical"

    Payer System Pharmacy Claim Load
    ReceivedClaimType

    "Pharmacy"

    Received Claim Load
    ReceivedClaimType

    "Medical"

    Received Pharmacy Claim Load
    ReceivedClaimType

    "Pharmacy"

    TypeOfBillCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillCode
    MsspPartAClaimsHeader.CLM_BILL_CLSFCTN_CD
    MsspPartAClaimsHeader.CLM_BILL_FAC_TYPE_CD
    MsspPartAClaimsHeader.CLM_BILL_FREQ_CD

    Concatenation of CLM_BILL_FAC_TYPE_CD, CLM_BILL_CLSFCTN_CD, and CLM_BILL_FREQ_CD

    CMS ACO Part B DME File Load
    TypeOfBillCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    TypeOfBillCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    TypeOfBillCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Part B Claim Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    TypeOfBillCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Data Aggregation Pharmacy Claim Load
    TypeOfBillCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Externally Adjudicated Pharmacy Claim Load
    TypeOfBillCode

    "*Not Applicable"

    Payer System Medical Claim Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Payer System Pharmacy Claim Load
    TypeOfBillCode

    "*Not Applicable"

    Received Claim Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Received Pharmacy Claim Load
    TypeOfBillCode

    "*Not Applicable"

    FirstDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstDiagnosisType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    FirstDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FirstDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part D Prescription Drug File Load
    FirstDiagnosisType

    "*Not Applicable"

    CMS CJR DME Claim Load
    FirstDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    FirstDiagnosisType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    FirstDiagnosisType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    FirstDiagnosisType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    FirstDiagnosisType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Part B Claim Load
    FirstDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    FirstDiagnosisType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    FirstDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Data Aggregation Pharmacy Claim Load
    FirstDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated Medical Claim Load
    FirstDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then ZC_EDG_CODE_SET.NAME

    Externally Adjudicated Pharmacy Claim Load
    FirstDiagnosisType

    "*Not Applicable"

    Payer System Medical Claim Load
    FirstDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Payer System Pharmacy Claim Load
    FirstDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim Load
    FirstDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then ZC_EDG_CODE_SET.NAME

    Received Pharmacy Claim Load
    FirstDiagnosisType

    "*Not Applicable"

    FirstDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstDiagnosisCode
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 1

    CMS ACO Part B DME File Load
    FirstDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FirstDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 1 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    CMS ACO Part D Prescription Drug File Load
    FirstDiagnosisCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Part B Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    FirstDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    FirstDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Data Aggregation Pharmacy Claim Load
    FirstDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated Medical Claim Load
    FirstDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 1

    Externally Adjudicated Pharmacy Claim Load
    FirstDiagnosisCode

    "*Not Applicable"

    Payer System Medical Claim Load
    FirstDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Payer System Pharmacy Claim Load
    FirstDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim Load
    FirstDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 1

    Received Pharmacy Claim Load
    FirstDiagnosisCode

    "*Not Applicable"

    SecondDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondDiagnosisType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    SecondDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SecondDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type"

    CMS ACO Part D Prescription Drug File Load
    SecondDiagnosisType

    "*Not Applicable"

    CMS CJR DME Claim Load
    SecondDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    SecondDiagnosisType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    SecondDiagnosisType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    SecondDiagnosisType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    SecondDiagnosisType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Part B Claim Load
    SecondDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    SecondDiagnosisType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    SecondDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Data Aggregation Pharmacy Claim Load
    SecondDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated Medical Claim Load
    SecondDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then ZC_EDG_CODE_SET.NAME

    Externally Adjudicated Pharmacy Claim Load
    SecondDiagnosisType

    "*Not Applicable"

    Payer System Medical Claim Load
    SecondDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Payer System Pharmacy Claim Load
    SecondDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim Load
    SecondDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then ZC_EDG_CODE_SET.NAME

    Received Pharmacy Claim Load
    SecondDiagnosisType

    "*Not Applicable"

    SecondDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondDiagnosisCode
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 2

    CMS ACO Part B DME File Load
    SecondDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SecondDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 2 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    CMS ACO Part D Prescription Drug File Load
    SecondDiagnosisCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Part B Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    SecondDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    SecondDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Data Aggregation Pharmacy Claim Load
    SecondDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated Medical Claim Load
    SecondDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 2

    Externally Adjudicated Pharmacy Claim Load
    SecondDiagnosisCode

    "*Not Applicable"

    Payer System Medical Claim Load
    SecondDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Payer System Pharmacy Claim Load
    SecondDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim Load
    SecondDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 2

    Received Pharmacy Claim Load
    SecondDiagnosisCode

    "*Not Applicable"

    ThirdDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdDiagnosisType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    ThirdDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ThirdDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type"

    CMS ACO Part D Prescription Drug File Load
    ThirdDiagnosisType

    "*Not Applicable"

    CMS CJR DME Claim Load
    ThirdDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    ThirdDiagnosisType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    ThirdDiagnosisType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    ThirdDiagnosisType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    ThirdDiagnosisType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Part B Claim Load
    ThirdDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    ThirdDiagnosisType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    ThirdDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Data Aggregation Pharmacy Claim Load
    ThirdDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated Medical Claim Load
    ThirdDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then ZC_EDG_CODE_SET.NAME

    Externally Adjudicated Pharmacy Claim Load
    ThirdDiagnosisType

    "*Not Applicable"

    Payer System Medical Claim Load
    ThirdDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Payer System Pharmacy Claim Load
    ThirdDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim Load
    ThirdDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then ZC_EDG_CODE_SET.NAME

    Received Pharmacy Claim Load
    ThirdDiagnosisType

    "*Not Applicable"

    ThirdDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdDiagnosisCode
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 3

    CMS ACO Part B DME File Load
    ThirdDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ThirdDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 3 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    CMS ACO Part D Prescription Drug File Load
    ThirdDiagnosisCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Part B Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    ThirdDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    ThirdDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Data Aggregation Pharmacy Claim Load
    ThirdDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated Medical Claim Load
    ThirdDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 3

    Externally Adjudicated Pharmacy Claim Load
    ThirdDiagnosisCode

    "*Not Applicable"

    Payer System Medical Claim Load
    ThirdDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Payer System Pharmacy Claim Load
    ThirdDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim Load
    ThirdDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 3

    Received Pharmacy Claim Load
    ThirdDiagnosisCode

    "*Not Applicable"

    FourthDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FourthDiagnosisType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    FourthDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FourthDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type"

    CMS ACO Part D Prescription Drug File Load
    FourthDiagnosisType

    "*Not Applicable"

    CMS CJR DME Claim Load
    FourthDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    FourthDiagnosisType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    FourthDiagnosisType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    FourthDiagnosisType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    FourthDiagnosisType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Part B Claim Load
    FourthDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    FourthDiagnosisType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    FourthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Data Aggregation Pharmacy Claim Load
    FourthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated Medical Claim Load
    FourthDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then ZC_EDG_CODE_SET.NAME

    Externally Adjudicated Pharmacy Claim Load
    FourthDiagnosisType

    "*Not Applicable"

    Payer System Medical Claim Load
    FourthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Payer System Pharmacy Claim Load
    FourthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim Load
    FourthDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then ZC_EDG_CODE_SET.NAME

    Received Pharmacy Claim Load
    FourthDiagnosisType

    "*Not Applicable"

    FourthDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FourthDiagnosisCode
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 4

    CMS ACO Part B DME File Load
    FourthDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FourthDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 4 by ( where DGNS_PRCDR_ICD_IND = 9 - ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    CMS ACO Part D Prescription Drug File Load
    FourthDiagnosisCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Part B Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    FourthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    FourthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Data Aggregation Pharmacy Claim Load
    FourthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated Medical Claim Load
    FourthDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 4

    Externally Adjudicated Pharmacy Claim Load
    FourthDiagnosisCode

    "*Not Applicable"

    Payer System Medical Claim Load
    FourthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Payer System Pharmacy Claim Load
    FourthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim Load
    FourthDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 4

    Received Pharmacy Claim Load
    FourthDiagnosisCode

    "*Not Applicable"

    FifthDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FifthDiagnosisType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    FifthDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FifthDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type"

    CMS ACO Part D Prescription Drug File Load
    FifthDiagnosisType

    "*Not Applicable"

    CMS CJR DME Claim Load
    FifthDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    FifthDiagnosisType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    FifthDiagnosisType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    FifthDiagnosisType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    FifthDiagnosisType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Part B Claim Load
    FifthDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    FifthDiagnosisType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    FifthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Data Aggregation Pharmacy Claim Load
    FifthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated Medical Claim Load
    FifthDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then ZC_EDG_CODE_SET.NAME

    Externally Adjudicated Pharmacy Claim Load
    FifthDiagnosisType

    "*Not Applicable"

    Payer System Medical Claim Load
    FifthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Payer System Pharmacy Claim Load
    FifthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim Load
    FifthDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then ZC_EDG_CODE_SET.NAME

    Received Pharmacy Claim Load
    FifthDiagnosisType

    "*Not Applicable"

    FifthDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FifthDiagnosisCode
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 5

    CMS ACO Part B DME File Load
    FifthDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FifthDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 5 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    CMS ACO Part D Prescription Drug File Load
    FifthDiagnosisCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Part B Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    FifthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    FifthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Data Aggregation Pharmacy Claim Load
    FifthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated Medical Claim Load
    FifthDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 5

    Externally Adjudicated Pharmacy Claim Load
    FifthDiagnosisCode

    "*Not Applicable"

    Payer System Medical Claim Load
    FifthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Payer System Pharmacy Claim Load
    FifthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim Load
    FifthDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 5

    Received Pharmacy Claim Load
    FifthDiagnosisCode

    "*Not Applicable"

    SixthDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SixthDiagnosisType
    MsspPartADiagnosisCode.DGNS_PRCDR_ICD_IND
    MsspPartADiagnosisCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    SixthDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SixthDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM Otherwise "Unknown Code Type"

    CMS ACO Part D Prescription Drug File Load
    SixthDiagnosisType

    "*Not Applicable"

    CMS CJR DME Claim Load
    SixthDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    SixthDiagnosisType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    SixthDiagnosisType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    SixthDiagnosisType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    SixthDiagnosisType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Part B Claim Load
    SixthDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    SixthDiagnosisType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If CODE_VALUE is NULL then *Unspecified Otherwise if DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    SixthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Data Aggregation Pharmacy Claim Load
    SixthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated Medical Claim Load
    SixthDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 6 then ZC_EDG_CODE_SET.NAME

    Externally Adjudicated Pharmacy Claim Load
    SixthDiagnosisType

    "*Not Applicable"

    Payer System Medical Claim Load
    SixthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Payer System Pharmacy Claim Load
    SixthDiagnosisType
    AP_CLAIM_DX.AP_DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim Load
    SixthDiagnosisType
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 6 then ZC_EDG_CODE_SET.NAME

    Received Pharmacy Claim Load
    SixthDiagnosisType

    "*Not Applicable"

    SixthDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SixthDiagnosisCode
    MsspPartADiagnosisCode.CLM_DGNS_CD
    MsspPartADiagnosisCode.CLM_VAL_SQNC_NUM

    CLM_DGNS_CD where CLM_VAL_SQNC_NUM = 6

    CMS ACO Part B DME File Load
    SixthDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SixthDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    MsspPartBPhysicians.CLM_DGNS_10_CD
    MsspPartBPhysicians.CLM_DGNS_11_CD
    MsspPartBPhysicians.CLM_DGNS_12_CD
    MsspPartBPhysicians.CLM_DGNS_2_CD
    MsspPartBPhysicians.CLM_DGNS_3_CD
    MsspPartBPhysicians.CLM_DGNS_4_CD
    MsspPartBPhysicians.CLM_DGNS_5_CD
    MsspPartBPhysicians.CLM_DGNS_6_CD
    MsspPartBPhysicians.CLM_DGNS_7_CD
    MsspPartBPhysicians.CLM_DGNS_8_CD
    MsspPartBPhysicians.CLM_DGNS_9_CD
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND

    Unpivot CLM_DGNS_1_CD, CLM_DGNS_2_CD, CLM_DGNS_3_CD, CLM_DGNS_4_CD, CLM_DGNS_5_CD, CLM_DGNS_6_CD, CLM_DGNS_7_CD, CLM_DGNS_8_CD, CLM_DGNS_9_CD, CLM_DGNS_10_CD, CLM_DGNS_11_CD, CLM_DGNS_12_CD where row is numbered 6 by ( where DGNS_PRCDR_ICD_IND = 9-ICD 9 or DGNS_PRCDR_ICD_IND = 0-ICD 10 then 1 otherwise 2 ) then by minimum pivoted column name for each CUR_CLM_UNIQ_ID and CUR_CLM_UNIQ_ID is not NULL and unpivoted column is not NULL

    CMS ACO Part D Prescription Drug File Load
    SixthDiagnosisCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Home Health Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Hospice Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Inpatient Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Outpatient Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Part B Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    CMS CJR Skilled Nursing Facility Claim Load
    SixthDiagnosisCode

    If CODE_VALUE is not NULL then CODE_VALUE Otherwise *Unspecified

    Data Aggregation Medical Claim Load
    SixthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Data Aggregation Pharmacy Claim Load
    SixthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated Medical Claim Load
    SixthDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 6

    Externally Adjudicated Pharmacy Claim Load
    SixthDiagnosisCode

    "*Not Applicable"

    Payer System Medical Claim Load
    SixthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Payer System Pharmacy Claim Load
    SixthDiagnosisCode
    AP_CLAIM_DX.AP_DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim Load
    SixthDiagnosisCode
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_CLAIM_DX.LINE = 6

    Received Pharmacy Claim Load
    SixthDiagnosisCode

    "*Not Applicable"

    BillingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderSpecialty

    *Not Applicable

    Data Aggregation Medical Claim Load
    BillingProviderSpecialty
    CLM_VALUES_5.BIL_PROV_SPECIALTY
    Data Aggregation Pharmacy Claim Load
    BillingProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderSpecialty

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderSpecialty
    CLM_VALUES_5.BIL_PROV_SPECIALTY
    Payer System Pharmacy Claim Load
    BillingProviderSpecialty

    "*Not Applicable"

    Received Claim Load
    BillingProviderSpecialty
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Received Pharmacy Claim Load
    BillingProviderSpecialty

    "*Not Applicable"

    ReferringProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderSpecialty

    *Not Applicable

    Data Aggregation Pharmacy Claim Load
    ReferringProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderSpecialty

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    ReferringProviderSpecialty

    "*Not Applicable"

    Received Claim Load
    ReferringProviderSpecialty
    CLARITY_SER_SPEC.SPECIALTY_C
    CLM_VALUES_2.REF_PROV_TAXONOMY
    ZC_SPECIALTY.NAME
    ZC_SPECIALTY.SPECIALTY_C

    If REF_PROV_TAXONOMY is not NULL then REF_PROV_TAXONOMY Otherwise if CLARITY_SER_SPEC.SPECIALTY_C is NULL then "*Unspecified" Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then "*Unknown" Otherwise NAME

    Received Pharmacy Claim Load
    ReferringProviderSpecialty

    "*Not Applicable"

    RenderingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderSpecialty

    *Not Applicable

    Data Aggregation Pharmacy Claim Load
    RenderingProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderSpecialty

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    RenderingProviderSpecialty

    "*Not Applicable"

    Received Claim Load
    RenderingProviderSpecialty
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_2.REND_PROV_TAXONOMY
    CLM_VALUES_3.ASST_SURG_NPI
    CLM_VALUES_3.ASST_SURG_TAXONOMY

    If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY

    Received Pharmacy Claim Load
    RenderingProviderSpecialty

    "*Not Applicable"

    AttendingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderSpecialty

    *Not Applicable

    Data Aggregation Medical Claim Load
    AttendingProviderSpecialty
    CLM_VALUES_5.ATT_PROV_SPECIALTY
    Data Aggregation Pharmacy Claim Load
    AttendingProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderSpecialty

    "*Not Applicable"

    Payer System Medical Claim Load
    AttendingProviderSpecialty
    CLM_VALUES_5.ATT_PROV_SPECIALTY
    Payer System Pharmacy Claim Load
    AttendingProviderSpecialty

    "*Not Applicable"

    Received Claim Load
    AttendingProviderSpecialty
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Received Pharmacy Claim Load
    AttendingProviderSpecialty

    "*Not Applicable"

    OperatingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderSpecialty

    *Not Applicable

    Data Aggregation Medical Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Data Aggregation Pharmacy Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Payer System Medical Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Received Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    Received Pharmacy Claim Load
    OperatingProviderSpecialty

    "*Not Applicable"

    OtherProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderSpecialty

    *Not Applicable

    Data Aggregation Medical Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Data Aggregation Pharmacy Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Payer System Medical Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Received Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    Received Pharmacy Claim Load
    OtherProviderSpecialty

    "*Not Applicable"

    PrescribingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    PrescribingProviderSpecialty

    *Not Applicable

    Data Aggregation Medical Claim Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    Data Aggregation Pharmacy Claim Load
    PrescribingProviderSpecialty

    "*Unspecified"

    Externally Adjudicated Medical Claim Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    PrescribingProviderSpecialty
    AP_CLM_RX.PRESC_PROV_TAXONOMY
    Payer System Medical Claim Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    PrescribingProviderSpecialty

    "*Unspecified"

    Received Claim Load
    PrescribingProviderSpecialty

    "*Not Applicable"

    Received Pharmacy Claim Load
    PrescribingProviderSpecialty
    AP_CLM_RX.PRESC_PROV_TAXONOMY

    ServiceProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ServiceProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ServiceProviderSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ServiceProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    CMS CJR Hospice Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    Data Aggregation Medical Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    Data Aggregation Pharmacy Claim Load
    ServiceProviderSpecialty

    "*Unspecified"

    Externally Adjudicated Medical Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    Externally Adjudicated Pharmacy Claim Load
    ServiceProviderSpecialty

    "*Unspecified"

    Payer System Medical Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    Payer System Pharmacy Claim Load
    ServiceProviderSpecialty

    "*Unspecified"

    Received Claim Load
    ServiceProviderSpecialty

    *Not Applicable

    Received Pharmacy Claim Load
    ServiceProviderSpecialty

    "*Unspecified"

    BillingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    BillingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Pharmacy Claim Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    BillingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderCmsSpecialtyCode

    NULL

    Payer System Pharmacy Claim Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    Received Claim Load
    BillingProviderCmsSpecialtyCode

    NULL

    Received Pharmacy Claim Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    BillingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    BillingProviderCmsSpecialtyName

    NULL

    Data Aggregation Pharmacy Claim Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    BillingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderCmsSpecialtyName

    NULL

    Payer System Pharmacy Claim Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    Received Claim Load
    BillingProviderCmsSpecialtyName

    NULL

    Received Pharmacy Claim Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    ReferringProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Data Aggregation Pharmacy Claim Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Payer System Pharmacy Claim Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    Received Claim Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Received Pharmacy Claim Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    ReferringProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    ReferringProviderCmsSpecialtyName

    NULL

    Data Aggregation Pharmacy Claim Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    ReferringProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    Payer System Medical Claim Load
    ReferringProviderCmsSpecialtyName

    NULL

    Payer System Pharmacy Claim Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    Received Claim Load
    ReferringProviderCmsSpecialtyName

    NULL

    Received Pharmacy Claim Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    RenderingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Pharmacy Claim Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Payer System Pharmacy Claim Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    Received Claim Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Received Pharmacy Claim Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    RenderingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    RenderingProviderCmsSpecialtyName

    NULL

    Data Aggregation Pharmacy Claim Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    RenderingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    Payer System Medical Claim Load
    RenderingProviderCmsSpecialtyName

    NULL

    Payer System Pharmacy Claim Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    Received Claim Load
    RenderingProviderCmsSpecialtyName

    NULL

    Received Pharmacy Claim Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    AttendingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Pharmacy Claim Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Payer System Pharmacy Claim Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    Received Claim Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Received Pharmacy Claim Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    AttendingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    AttendingProviderCmsSpecialtyName

    NULL

    Data Aggregation Pharmacy Claim Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AttendingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    Payer System Medical Claim Load
    AttendingProviderCmsSpecialtyName

    NULL

    Payer System Pharmacy Claim Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    Received Claim Load
    AttendingProviderCmsSpecialtyName

    NULL

    Received Pharmacy Claim Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    OperatingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Pharmacy Claim Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Payer System Pharmacy Claim Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    Received Claim Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Received Pharmacy Claim Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    OperatingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    OperatingProviderCmsSpecialtyName

    NULL

    Data Aggregation Pharmacy Claim Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OperatingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    Payer System Medical Claim Load
    OperatingProviderCmsSpecialtyName

    NULL

    Payer System Pharmacy Claim Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    Received Claim Load
    OperatingProviderCmsSpecialtyName

    NULL

    Received Pharmacy Claim Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    OtherProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    OtherProviderCmsSpecialtyCode

    NULL

    Data Aggregation Pharmacy Claim Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OtherProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    OtherProviderCmsSpecialtyCode

    NULL

    Payer System Pharmacy Claim Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    Received Claim Load
    OtherProviderCmsSpecialtyCode

    NULL

    Received Pharmacy Claim Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    OtherProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    OtherProviderCmsSpecialtyName

    NULL

    Data Aggregation Pharmacy Claim Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OtherProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    Payer System Medical Claim Load
    OtherProviderCmsSpecialtyName

    NULL

    Payer System Pharmacy Claim Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    Received Claim Load
    OtherProviderCmsSpecialtyName

    NULL

    Received Pharmacy Claim Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    BillingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Data Aggregation Pharmacy Claim Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Payer System Pharmacy Claim Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    Received Claim Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Received Pharmacy Claim Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    BillingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderTaxonomyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    BillingProviderTaxonomyName

    NULL

    Data Aggregation Pharmacy Claim Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    BillingProviderTaxonomyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderTaxonomyName

    NULL

    Payer System Pharmacy Claim Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    Received Claim Load
    BillingProviderTaxonomyName

    NULL

    Received Pharmacy Claim Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    ReferringProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    ReferringProviderTaxonomyCode
    CLM_VALUES_2.REF_PROV_TAXONOMY
    Data Aggregation Pharmacy Claim Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    ReferringProviderTaxonomyCode
    CLM_VALUES_2.REF_PROV_TAXONOMY
    Payer System Pharmacy Claim Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    Received Claim Load
    ReferringProviderTaxonomyCode
    CLM_VALUES_2.REF_PROV_TAXONOMY
    Received Pharmacy Claim Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    ReferringProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ReferringProviderTaxonomyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    ReferringProviderTaxonomyName

    NULL

    Data Aggregation Pharmacy Claim Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    ReferringProviderTaxonomyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    Payer System Medical Claim Load
    ReferringProviderTaxonomyName

    NULL

    Payer System Pharmacy Claim Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    Received Claim Load
    ReferringProviderTaxonomyName

    NULL

    Received Pharmacy Claim Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    RenderingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Pharmacy Claim Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    RenderingProviderTaxonomyCode
    CLM_VALUES_2.REND_PROV_TAXONOMY
    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    Received Claim Load
    RenderingProviderTaxonomyCode
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_2.REND_PROV_TAXONOMY
    CLM_VALUES_3.ASST_SURG_NPI
    CLM_VALUES_3.ASST_SURG_TAXONOMY

    If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY

    Received Pharmacy Claim Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    RenderingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    RenderingProviderTaxonomyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    RenderingProviderTaxonomyName

    NULL

    Data Aggregation Pharmacy Claim Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    RenderingProviderTaxonomyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    Payer System Medical Claim Load
    RenderingProviderTaxonomyName

    NULL

    Payer System Pharmacy Claim Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    Received Claim Load
    RenderingProviderTaxonomyName

    NULL

    Received Pharmacy Claim Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    AttendingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Data Aggregation Pharmacy Claim Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Payer System Pharmacy Claim Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    Received Claim Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Received Pharmacy Claim Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    AttendingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    AttendingProviderTaxonomyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    AttendingProviderTaxonomyName

    NULL

    Data Aggregation Pharmacy Claim Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    AttendingProviderTaxonomyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    Payer System Medical Claim Load
    AttendingProviderTaxonomyName

    NULL

    Payer System Pharmacy Claim Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    Received Claim Load
    AttendingProviderTaxonomyName

    NULL

    Received Pharmacy Claim Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    OperatingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    OperatingProviderTaxonomyCode
    CLM_VALUES_5.OPER_PROV_TAXONOMY
    Data Aggregation Pharmacy Claim Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    OperatingProviderTaxonomyCode
    CLM_VALUES_5.OPER_PROV_TAXONOMY
    Payer System Pharmacy Claim Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    Received Claim Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    Received Pharmacy Claim Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    OperatingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OperatingProviderTaxonomyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    OperatingProviderTaxonomyName

    NULL

    Data Aggregation Pharmacy Claim Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OperatingProviderTaxonomyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    Payer System Medical Claim Load
    OperatingProviderTaxonomyName

    NULL

    Payer System Pharmacy Claim Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    Received Claim Load
    OperatingProviderTaxonomyName

    NULL

    Received Pharmacy Claim Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    OtherProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Hospice Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Medical Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Data Aggregation Pharmacy Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Payer System Medical Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Payer System Pharmacy Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Received Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    Received Pharmacy Claim Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    OtherProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Hospice Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    OtherProviderTaxonomyName

    *Not Applicable

    Data Aggregation Medical Claim Load
    OtherProviderTaxonomyName

    NULL

    Data Aggregation Pharmacy Claim Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    OtherProviderTaxonomyName

    NULL

    Externally Adjudicated Pharmacy Claim Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    Payer System Medical Claim Load
    OtherProviderTaxonomyName

    NULL

    Payer System Pharmacy Claim Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    Received Claim Load
    OtherProviderTaxonomyName

    NULL

    Received Pharmacy Claim Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    FirstClaimTrait

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstClaimTrait

    "*Not Applicable"

    CMS ACO Part B DME File Load
    FirstClaimTrait

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FirstClaimTrait

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    FirstClaimTrait

    "*Not Applicable"

    CMS CJR DME Claim Load
    FirstClaimTrait

    NULL

    CMS CJR Home Health Claim Load
    FirstClaimTrait

    NULL

    CMS CJR Hospice Claim Load
    FirstClaimTrait

    NULL

    CMS CJR Inpatient Claim Load
    FirstClaimTrait

    NULL

    CMS CJR Outpatient Claim Load
    FirstClaimTrait

    NULL

    CMS CJR Part B Claim Load
    FirstClaimTrait

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    FirstClaimTrait

    NULL

    Data Aggregation Pharmacy Claim Load
    FirstClaimTrait

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    FirstClaimTrait

    "*Unspecified"

    Payer System Pharmacy Claim Load
    FirstClaimTrait

    "*Unspecified"

    Received Claim Load
    FirstClaimTrait
    AP_CLAIM_2.CLM_TRAIT_1_C
    ZC_CLM_TRAIT_1.CLM_TRAIT_1_C
    ZC_CLM_TRAIT_1.NAME

    If AP_CLAIM_2.CLM_TRAIT_1_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_1.CLM_TRAIT_1_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_1.NAME

    Received Pharmacy Claim Load
    FirstClaimTrait

    "*Unspecified"

    SecondClaimTrait

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondClaimTrait

    "*Not Applicable"

    CMS ACO Part B DME File Load
    SecondClaimTrait

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SecondClaimTrait

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    SecondClaimTrait

    "*Not Applicable"

    CMS CJR DME Claim Load
    SecondClaimTrait

    NULL

    CMS CJR Home Health Claim Load
    SecondClaimTrait

    NULL

    CMS CJR Hospice Claim Load
    SecondClaimTrait

    NULL

    CMS CJR Inpatient Claim Load
    SecondClaimTrait

    NULL

    CMS CJR Outpatient Claim Load
    SecondClaimTrait

    NULL

    CMS CJR Part B Claim Load
    SecondClaimTrait

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    SecondClaimTrait

    NULL

    Data Aggregation Pharmacy Claim Load
    SecondClaimTrait

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    SecondClaimTrait

    "*Unspecified"

    Payer System Pharmacy Claim Load
    SecondClaimTrait

    "*Unspecified"

    Received Claim Load
    SecondClaimTrait
    AP_CLAIM_2.CLM_TRAIT_2_C
    ZC_CLM_TRAIT_2.CLM_TRAIT_2_C
    ZC_CLM_TRAIT_2.NAME

    If AP_CLAIM_2.CLM_TRAIT_2_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_2.CLM_TRAIT_2_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_2.NAME

    Received Pharmacy Claim Load
    SecondClaimTrait

    "*Unspecified"

    ThirdClaimTrait

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdClaimTrait

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ThirdClaimTrait

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ThirdClaimTrait

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ThirdClaimTrait

    "*Not Applicable"

    CMS CJR DME Claim Load
    ThirdClaimTrait

    NULL

    CMS CJR Home Health Claim Load
    ThirdClaimTrait

    NULL

    CMS CJR Hospice Claim Load
    ThirdClaimTrait

    NULL

    CMS CJR Inpatient Claim Load
    ThirdClaimTrait

    NULL

    CMS CJR Outpatient Claim Load
    ThirdClaimTrait

    NULL

    CMS CJR Part B Claim Load
    ThirdClaimTrait

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ThirdClaimTrait

    NULL

    Data Aggregation Pharmacy Claim Load
    ThirdClaimTrait

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    ThirdClaimTrait

    "*Unspecified"

    Payer System Pharmacy Claim Load
    ThirdClaimTrait

    "*Unspecified"

    Received Claim Load
    ThirdClaimTrait
    AP_CLAIM_2.CLM_TRAIT_3_C
    ZC_CLM_TRAIT_3.CLM_TRAIT_3_C
    ZC_CLM_TRAIT_3.NAME

    If AP_CLAIM_2.CLM_TRAIT_3_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_3.CLM_TRAIT_3_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_3.NAME

    Received Pharmacy Claim Load
    ThirdClaimTrait

    "*Unspecified"

    FourthClaimTrait

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FourthClaimTrait

    "*Not Applicable"

    CMS ACO Part B DME File Load
    FourthClaimTrait

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FourthClaimTrait

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    FourthClaimTrait

    "*Not Applicable"

    CMS CJR DME Claim Load
    FourthClaimTrait

    NULL

    CMS CJR Home Health Claim Load
    FourthClaimTrait

    NULL

    CMS CJR Hospice Claim Load
    FourthClaimTrait

    NULL

    CMS CJR Inpatient Claim Load
    FourthClaimTrait

    NULL

    CMS CJR Outpatient Claim Load
    FourthClaimTrait

    NULL

    CMS CJR Part B Claim Load
    FourthClaimTrait

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    FourthClaimTrait

    NULL

    Data Aggregation Pharmacy Claim Load
    FourthClaimTrait

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    FourthClaimTrait

    "*Unspecified"

    Payer System Pharmacy Claim Load
    FourthClaimTrait

    "*Unspecified"

    Received Claim Load
    FourthClaimTrait
    AP_CLAIM_2.CLM_TRAIT_4_C
    ZC_CLM_TRAIT_4.CLM_TRAIT_4_C
    ZC_CLM_TRAIT_4.NAME

    If AP_CLAIM_2.CLM_TRAIT_4_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_4.CLM_TRAIT_4_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_4.NAME

    Received Pharmacy Claim Load
    FourthClaimTrait

    "*Unspecified"

    FifthClaimTrait

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FifthClaimTrait

    "*Not Applicable"

    CMS ACO Part B DME File Load
    FifthClaimTrait

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FifthClaimTrait

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    FifthClaimTrait

    "*Not Applicable"

    CMS CJR DME Claim Load
    FifthClaimTrait

    NULL

    CMS CJR Home Health Claim Load
    FifthClaimTrait

    NULL

    CMS CJR Hospice Claim Load
    FifthClaimTrait

    NULL

    CMS CJR Inpatient Claim Load
    FifthClaimTrait

    NULL

    CMS CJR Outpatient Claim Load
    FifthClaimTrait

    NULL

    CMS CJR Part B Claim Load
    FifthClaimTrait

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    FifthClaimTrait

    NULL

    Data Aggregation Pharmacy Claim Load
    FifthClaimTrait

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    FifthClaimTrait

    "*Unspecified"

    Payer System Pharmacy Claim Load
    FifthClaimTrait

    "*Unspecified"

    Received Claim Load
    FifthClaimTrait
    AP_CLAIM_2.CLM_TRAIT_5_C
    ZC_CLM_TRAIT_5.CLM_TRAIT_5_C
    ZC_CLM_TRAIT_5.NAME

    If AP_CLAIM_2.CLM_TRAIT_5_C is NULL then "*Unspecified" Otherwise if ZC_CLM_TRAIT_5.CLM_TRAIT_5_C is NULL then "*Unknown" Otherwise ZC_CLM_TRAIT_5.NAME

    Received Pharmacy Claim Load
    FifthClaimTrait

    "*Unspecified"

    CarrierName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CarrierName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    CarrierName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    CarrierName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    CarrierName

    "*Not Applicable"

    CMS CJR DME Claim Load
    CarrierName

    NULL

    CMS CJR Home Health Claim Load
    CarrierName

    NULL

    CMS CJR Hospice Claim Load
    CarrierName

    NULL

    CMS CJR Inpatient Claim Load
    CarrierName

    NULL

    CMS CJR Outpatient Claim Load
    CarrierName

    NULL

    CMS CJR Part B Claim Load
    CarrierName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    CarrierName

    NULL

    Data Aggregation Pharmacy Claim Load
    CarrierName

    "*Unspecified"

    Externally Adjudicated Medical Claim Load
    CarrierName

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    CarrierName

    "*Unspecified"

    Payer System Pharmacy Claim Load
    CarrierName

    "*Unspecified"

    Received Claim Load
    CarrierName
    AP_CLAIM.PLAN_GROUP_ID
    AP_CLAIM.SERV_DATE
    AP_CLAIM.SERVICE_START_DATE
    CLARITY_CARRIER.CARRIER_ID
    CLARITY_CARRIER.CARRIER_NAME
    PLAN_GRP_BEN_PLAN.BEN_PLAN_CAR_ID

    If there does not exist a row in PLAN_GRP_BEN_PLAN for AP_CLAIM.PLAN_GROUP_ID effective on SERVICE_START_DATE if populated, SERV_DATE if not, then "*Unspecified" Otherwise if PLAN_GRP_BEN_PLAN.BEN_PLAN_CAR_ID is NULL then "*Unspecified" Otherwise if CARRIER_ID is NULL then "*Unknown" Otherwise CARRIER_NAME

    Received Pharmacy Claim Load
    CarrierName

    "*Unspecified"

    Ccn

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    Ccn
    MsspPartAClaimsHeader.PRVDR_OSCAR_NUM
    CMS ACO Part B DME File Load
    Ccn

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    Ccn

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    Ccn

    "*Not Applicable"

    CMS CJR DME Claim Load
    Ccn

    NULL

    CMS CJR Home Health Claim Load
    Ccn
    CmsCjrHomeHealthHeader.CLM_PROVIDER
    CMS CJR Hospice Claim Load
    Ccn
    CmsCjrHospiceHeader.CLM_PROVIDER
    CMS CJR Inpatient Claim Load
    Ccn
    CmsCjrInpatientHeader.CLM_PROVIDER
    CMS CJR Outpatient Claim Load
    Ccn
    CmsCjrOutpatientHeader.CLM_PROVIDER
    CMS CJR Part B Claim Load
    Ccn

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    Ccn
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    Data Aggregation Medical Claim Load
    Ccn
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    Data Aggregation Pharmacy Claim Load
    Ccn

    "*Unspecified"

    Externally Adjudicated Medical Claim Load
    Ccn

    NULL

    Externally Adjudicated Pharmacy Claim Load
    Ccn

    "*Unspecified"

    Payer System Medical Claim Load
    Ccn
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    Payer System Pharmacy Claim Load
    Ccn

    "*Unspecified"

    Received Claim Load
    Ccn

    NULL

    Received Pharmacy Claim Load
    Ccn

    "*Unspecified"

    BillingProviderNpi

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderNpi
    CMS ACO Part B DME File Load
    BillingProviderNpi
    CMS ACO Part B Physicians File Load
    BillingProviderNpi
    CMS ACO Part D Prescription Drug File Load
    BillingProviderNpi
    CMS CJR DME Claim Load
    BillingProviderNpi
    CMS CJR Home Health Claim Load
    BillingProviderNpi
    CMS CJR Hospice Claim Load
    BillingProviderNpi
    CMS CJR Inpatient Claim Load
    BillingProviderNpi
    CMS CJR Outpatient Claim Load
    BillingProviderNpi
    CMS CJR Part B Claim Load
    BillingProviderNpi
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderNpi
    Data Aggregation Medical Claim Load
    BillingProviderNpi
    CLM_VALUES.BIL_PROV_NPI
    Externally Adjudicated Medical Claim Load
    BillingProviderNpi
    CLM_VALUES.BIL_PROV_NPI
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderNpi

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderNpi
    CLM_VALUES.BIL_PROV_NPI
    Received Claim Load
    BillingProviderNpi
    CLM_VALUES.BIL_PROV_NPI
    Received Pharmacy Claim Load
    BillingProviderNpi

    "*Not Applicable"

    BillingProviderName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderName
    CMS ACO Part B DME File Load
    BillingProviderName
    CMS ACO Part B Physicians File Load
    BillingProviderName
    CMS ACO Part D Prescription Drug File Load
    BillingProviderName
    CMS CJR DME Claim Load
    BillingProviderName
    CMS CJR Home Health Claim Load
    BillingProviderName
    CMS CJR Hospice Claim Load
    BillingProviderName
    CMS CJR Inpatient Claim Load
    BillingProviderName
    CMS CJR Outpatient Claim Load
    BillingProviderName
    CMS CJR Part B Claim Load
    BillingProviderName
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderName
    Data Aggregation Medical Claim Load
    BillingProviderName
    CLM_VALUES.BIL_PROV_NAM_LAST
    CLM_VALUES.BIL_PROV_TYP_QUAL
    Externally Adjudicated Medical Claim Load
    BillingProviderName
    CLM_VALUES.BIL_PROV_NAM_LAST
    CLM_VALUES.BIL_PROV_TYP_QUAL

    If BIL_PROV_TYP_QUAL = "2" then BIL_PROV_NAM_LAST

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderName

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderName
    CLM_VALUES.BIL_PROV_NAM_LAST
    CLM_VALUES.BIL_PROV_TYP_QUAL
    Received Claim Load
    BillingProviderName
    CLM_VALUES.BIL_PROV_NAM_LAST
    CLM_VALUES.BIL_PROV_TYP_QUAL

    If BIL_PROV_TYP_QUAL = "2" then BIL_PROV_NAM_LAST

    Received Pharmacy Claim Load
    BillingProviderName

    "*Not Applicable"

    BillingProviderLastName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderLastName
    CMS ACO Part B DME File Load
    BillingProviderLastName
    CMS ACO Part B Physicians File Load
    BillingProviderLastName
    CMS ACO Part D Prescription Drug File Load
    BillingProviderLastName
    CMS CJR DME Claim Load
    BillingProviderLastName
    CMS CJR Home Health Claim Load
    BillingProviderLastName
    CMS CJR Hospice Claim Load
    BillingProviderLastName
    CMS CJR Inpatient Claim Load
    BillingProviderLastName
    CMS CJR Outpatient Claim Load
    BillingProviderLastName
    CMS CJR Part B Claim Load
    BillingProviderLastName
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderLastName
    Data Aggregation Medical Claim Load
    BillingProviderLastName
    CLM_VALUES.BIL_PROV_NAM_LAST
    Externally Adjudicated Medical Claim Load
    BillingProviderLastName
    CLM_VALUES.BIL_PROV_NAM_LAST
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderLastName
    Payer System Medical Claim Load
    BillingProviderLastName
    CLM_VALUES.BIL_PROV_NAM_LAST
    Received Claim Load
    BillingProviderLastName
    CLM_VALUES.BIL_PROV_NAM_LAST
    Received Pharmacy Claim Load
    BillingProviderLastName

    BillingProviderFirstName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderFirstName
    CMS ACO Part B DME File Load
    BillingProviderFirstName
    CMS ACO Part B Physicians File Load
    BillingProviderFirstName
    CMS ACO Part D Prescription Drug File Load
    BillingProviderFirstName
    CMS CJR DME Claim Load
    BillingProviderFirstName
    CMS CJR Home Health Claim Load
    BillingProviderFirstName
    CMS CJR Hospice Claim Load
    BillingProviderFirstName
    CMS CJR Inpatient Claim Load
    BillingProviderFirstName
    CMS CJR Outpatient Claim Load
    BillingProviderFirstName
    CMS CJR Part B Claim Load
    BillingProviderFirstName
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderFirstName
    Data Aggregation Medical Claim Load
    BillingProviderFirstName
    CLM_VALUES.BIL_PROV_NAM_FIRST
    Externally Adjudicated Medical Claim Load
    BillingProviderFirstName
    CLM_VALUES.BIL_PROV_NAM_FIRST
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderFirstName
    Payer System Medical Claim Load
    BillingProviderFirstName
    CLM_VALUES.BIL_PROV_NAM_FIRST
    Received Claim Load
    BillingProviderFirstName
    CLM_VALUES.BIL_PROV_NAM_FIRST
    Received Pharmacy Claim Load
    BillingProviderFirstName

    BillingProviderMiddleName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderMiddleName
    CMS ACO Part B DME File Load
    BillingProviderMiddleName
    CMS ACO Part B Physicians File Load
    BillingProviderMiddleName
    CMS ACO Part D Prescription Drug File Load
    BillingProviderMiddleName
    CMS CJR DME Claim Load
    BillingProviderMiddleName
    CMS CJR Home Health Claim Load
    BillingProviderMiddleName
    CMS CJR Hospice Claim Load
    BillingProviderMiddleName
    CMS CJR Inpatient Claim Load
    BillingProviderMiddleName
    CMS CJR Outpatient Claim Load
    BillingProviderMiddleName
    CMS CJR Part B Claim Load
    BillingProviderMiddleName
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderMiddleName
    Data Aggregation Medical Claim Load
    BillingProviderMiddleName
    CLM_VALUES.BIL_PROV_NAM_MID
    Externally Adjudicated Medical Claim Load
    BillingProviderMiddleName
    CLM_VALUES.BIL_PROV_NAM_MID
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderMiddleName
    Payer System Medical Claim Load
    BillingProviderMiddleName
    CLM_VALUES.BIL_PROV_NAM_MID
    Received Claim Load
    BillingProviderMiddleName
    CLM_VALUES.BIL_PROV_NAM_MID
    Received Pharmacy Claim Load
    BillingProviderMiddleName

    BillingProviderAddress

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(250)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderAddress
    CMS ACO Part B DME File Load
    BillingProviderAddress
    CMS ACO Part B Physicians File Load
    BillingProviderAddress
    CMS ACO Part D Prescription Drug File Load
    BillingProviderAddress
    CMS CJR DME Claim Load
    BillingProviderAddress
    CMS CJR Home Health Claim Load
    BillingProviderAddress
    CMS CJR Hospice Claim Load
    BillingProviderAddress
    CMS CJR Inpatient Claim Load
    BillingProviderAddress
    CMS CJR Outpatient Claim Load
    BillingProviderAddress
    CMS CJR Part B Claim Load
    BillingProviderAddress
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderAddress
    Data Aggregation Medical Claim Load
    BillingProviderAddress
    CLM_VALUES.BIL_PROV_ADDR_1
    CLM_VALUES.BIL_PROV_ADDR_2

    If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2

    Externally Adjudicated Medical Claim Load
    BillingProviderAddress
    CLM_VALUES.BIL_PROV_ADDR_1
    CLM_VALUES.BIL_PROV_ADDR_2

    If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2

    Externally Adjudicated Pharmacy Claim Load
    BillingProviderAddress

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderAddress
    CLM_VALUES.BIL_PROV_ADDR_1
    CLM_VALUES.BIL_PROV_ADDR_2

    If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2

    Received Claim Load
    BillingProviderAddress
    CLM_VALUES.BIL_PROV_ADDR_1
    CLM_VALUES.BIL_PROV_ADDR_2

    If BIL_PROV_ADDR_1 is NULL then BIL_PROV_ADDR_2 Otherwise if BIL_PROV_ADDR_2 is NULL then BIL_PROV_ADDR_1 Otherwise BIL_PROV_ADDR_1 + " " + BIL_PROV_ADDR_2

    Received Pharmacy Claim Load
    BillingProviderAddress

    "*Not Applicable"

    BillingProviderCity

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderCity
    CMS ACO Part B DME File Load
    BillingProviderCity
    CMS ACO Part B Physicians File Load
    BillingProviderCity
    CMS ACO Part D Prescription Drug File Load
    BillingProviderCity
    CMS CJR DME Claim Load
    BillingProviderCity
    CMS CJR Home Health Claim Load
    BillingProviderCity
    CMS CJR Hospice Claim Load
    BillingProviderCity
    CMS CJR Inpatient Claim Load
    BillingProviderCity
    CMS CJR Outpatient Claim Load
    BillingProviderCity
    CMS CJR Part B Claim Load
    BillingProviderCity
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderCity
    Data Aggregation Medical Claim Load
    BillingProviderCity
    CLM_VALUES.BIL_PROV_CITY
    Externally Adjudicated Medical Claim Load
    BillingProviderCity
    CLM_VALUES.BIL_PROV_CITY
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderCity

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderCity
    CLM_VALUES.BIL_PROV_CITY
    Received Claim Load
    BillingProviderCity
    CLM_VALUES.BIL_PROV_CITY
    Received Pharmacy Claim Load
    BillingProviderCity

    "*Not Applicable"

    BillingProviderStateOrProvince

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderStateOrProvince
    CMS ACO Part B DME File Load
    BillingProviderStateOrProvince
    CMS ACO Part B Physicians File Load
    BillingProviderStateOrProvince
    CMS ACO Part D Prescription Drug File Load
    BillingProviderStateOrProvince
    CMS CJR DME Claim Load
    BillingProviderStateOrProvince
    CMS CJR Home Health Claim Load
    BillingProviderStateOrProvince
    CMS CJR Hospice Claim Load
    BillingProviderStateOrProvince
    CMS CJR Inpatient Claim Load
    BillingProviderStateOrProvince
    CMS CJR Outpatient Claim Load
    BillingProviderStateOrProvince
    CMS CJR Part B Claim Load
    BillingProviderStateOrProvince
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderStateOrProvince
    Data Aggregation Medical Claim Load
    BillingProviderStateOrProvince
    CLM_VALUES.BIL_PROV_STATE
    Externally Adjudicated Medical Claim Load
    BillingProviderStateOrProvince
    CLM_VALUES.BIL_PROV_STATE
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderStateOrProvince

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderStateOrProvince
    CLM_VALUES.BIL_PROV_STATE
    Received Claim Load
    BillingProviderStateOrProvince
    CLM_VALUES.BIL_PROV_STATE
    Received Pharmacy Claim Load
    BillingProviderStateOrProvince

    "*Not Applicable"

    BillingProviderPostalCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderPostalCode
    CMS ACO Part B DME File Load
    BillingProviderPostalCode
    CMS ACO Part B Physicians File Load
    BillingProviderPostalCode
    CMS ACO Part D Prescription Drug File Load
    BillingProviderPostalCode
    CMS CJR DME Claim Load
    BillingProviderPostalCode
    CMS CJR Home Health Claim Load
    BillingProviderPostalCode
    CMS CJR Hospice Claim Load
    BillingProviderPostalCode
    CMS CJR Inpatient Claim Load
    BillingProviderPostalCode
    CMS CJR Outpatient Claim Load
    BillingProviderPostalCode
    CMS CJR Part B Claim Load
    BillingProviderPostalCode
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderPostalCode
    Data Aggregation Medical Claim Load
    BillingProviderPostalCode
    CLM_VALUES.BIL_PROV_ZIP
    Externally Adjudicated Medical Claim Load
    BillingProviderPostalCode
    CLM_VALUES.BIL_PROV_ZIP
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderPostalCode

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderPostalCode
    CLM_VALUES.BIL_PROV_ZIP
    Received Claim Load
    BillingProviderPostalCode
    CLM_VALUES.BIL_PROV_ZIP
    Received Pharmacy Claim Load
    BillingProviderPostalCode

    "*Not Applicable"

    BillingProviderCountry

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderCountry
    CMS ACO Part B DME File Load
    BillingProviderCountry
    CMS ACO Part B Physicians File Load
    BillingProviderCountry
    CMS ACO Part D Prescription Drug File Load
    BillingProviderCountry
    CMS CJR DME Claim Load
    BillingProviderCountry
    CMS CJR Home Health Claim Load
    BillingProviderCountry
    CMS CJR Hospice Claim Load
    BillingProviderCountry
    CMS CJR Inpatient Claim Load
    BillingProviderCountry
    CMS CJR Outpatient Claim Load
    BillingProviderCountry
    CMS CJR Part B Claim Load
    BillingProviderCountry
    CMS CJR Skilled Nursing Facility Claim Load
    BillingProviderCountry
    Data Aggregation Medical Claim Load
    BillingProviderCountry
    CLM_VALUES.BIL_PROV_CNTRY
    Externally Adjudicated Medical Claim Load
    BillingProviderCountry
    CLM_VALUES.BIL_PROV_CNTRY
    Externally Adjudicated Pharmacy Claim Load
    BillingProviderCountry

    "*Not Applicable"

    Payer System Medical Claim Load
    BillingProviderCountry
    CLM_VALUES.BIL_PROV_CNTRY
    Received Claim Load
    BillingProviderCountry
    CLM_VALUES.BIL_PROV_CNTRY
    Received Pharmacy Claim Load
    BillingProviderCountry

    "*Not Applicable"

    ServiceFacilityNpi

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityNpi
    CMS ACO Part B DME File Load
    ServiceFacilityNpi
    CMS ACO Part B Physicians File Load
    ServiceFacilityNpi
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityNpi
    CMS CJR DME Claim Load
    ServiceFacilityNpi
    CMS CJR Home Health Claim Load
    ServiceFacilityNpi
    CMS CJR Hospice Claim Load
    ServiceFacilityNpi
    CMS CJR Inpatient Claim Load
    ServiceFacilityNpi
    CMS CJR Outpatient Claim Load
    ServiceFacilityNpi
    CMS CJR Part B Claim Load
    ServiceFacilityNpi
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityNpi
    Data Aggregation Medical Claim Load
    ServiceFacilityNpi
    CLM_VALUES_3.SVC_FAC_NPI
    Externally Adjudicated Medical Claim Load
    ServiceFacilityNpi
    CLM_VALUES_3.SVC_FAC_NPI
    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityNpi

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityNpi
    CLM_VALUES_3.SVC_FAC_NPI
    Received Claim Load
    ServiceFacilityNpi
    CLM_VALUES_3.SVC_FAC_NPI
    Received Pharmacy Claim Load
    ServiceFacilityNpi

    "*Not Applicable"

    ServiceFacilityName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityName
    CMS ACO Part B DME File Load
    ServiceFacilityName
    CMS ACO Part B Physicians File Load
    ServiceFacilityName
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityName
    CMS CJR DME Claim Load
    ServiceFacilityName
    CMS CJR Home Health Claim Load
    ServiceFacilityName
    CMS CJR Hospice Claim Load
    ServiceFacilityName
    CMS CJR Inpatient Claim Load
    ServiceFacilityName
    CMS CJR Outpatient Claim Load
    ServiceFacilityName
    CMS CJR Part B Claim Load
    ServiceFacilityName
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityName
    Data Aggregation Medical Claim Load
    ServiceFacilityName
    CLM_VALUES_3.SVC_FAC_NAM
    Externally Adjudicated Medical Claim Load
    ServiceFacilityName
    CLM_VALUES_3.SVC_FAC_NAM
    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityName

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityName
    CLM_VALUES_3.SVC_FAC_NAM
    Received Claim Load
    ServiceFacilityName
    CLM_VALUES_3.SVC_FAC_NAM
    Received Pharmacy Claim Load
    ServiceFacilityName

    "*Not Applicable"

    ServiceFacilityPhoneNumber

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityPhoneNumber
    CMS ACO Part B DME File Load
    ServiceFacilityPhoneNumber
    CMS ACO Part B Physicians File Load
    ServiceFacilityPhoneNumber
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityPhoneNumber
    CMS CJR DME Claim Load
    ServiceFacilityPhoneNumber
    CMS CJR Home Health Claim Load
    ServiceFacilityPhoneNumber
    CMS CJR Hospice Claim Load
    ServiceFacilityPhoneNumber
    CMS CJR Inpatient Claim Load
    ServiceFacilityPhoneNumber
    CMS CJR Outpatient Claim Load
    ServiceFacilityPhoneNumber
    CMS CJR Part B Claim Load
    ServiceFacilityPhoneNumber
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityPhoneNumber
    Data Aggregation Medical Claim Load
    ServiceFacilityPhoneNumber
    CLM_VALUES_3.SVC_FAC_CNCT_PH
    Externally Adjudicated Medical Claim Load
    ServiceFacilityPhoneNumber
    CLM_VALUES_3.SVC_FAC_CNCT_EXT
    CLM_VALUES_3.SVC_FAC_CNCT_PH

    If SVC_FAC_CNCT_EXT is NULL then SVC_FAC_CNCT_PH Otherwise SVC_FAC_CNCT_PH + " EXT " + SVC_FAC_CNCT_EXT

    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityPhoneNumber

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityPhoneNumber
    CLM_VALUES_3.SVC_FAC_CNCT_PH
    Received Claim Load
    ServiceFacilityPhoneNumber
    CLM_VALUES_3.SVC_FAC_CNCT_EXT
    CLM_VALUES_3.SVC_FAC_CNCT_PH

    If SVC_FAC_CNCT_EXT is NULL then SVC_FAC_CNCT_PH Otherwise SVC_FAC_CNCT_PH + " EXT " + SVC_FAC_CNCT_EXT

    Received Pharmacy Claim Load
    ServiceFacilityPhoneNumber

    "*Not Applicable"

    ServiceFacilityAddress

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(250)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityAddress
    CMS ACO Part B DME File Load
    ServiceFacilityAddress
    CMS ACO Part B Physicians File Load
    ServiceFacilityAddress
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityAddress
    CMS CJR DME Claim Load
    ServiceFacilityAddress
    CMS CJR Home Health Claim Load
    ServiceFacilityAddress
    CMS CJR Hospice Claim Load
    ServiceFacilityAddress
    CMS CJR Inpatient Claim Load
    ServiceFacilityAddress
    CMS CJR Outpatient Claim Load
    ServiceFacilityAddress
    CMS CJR Part B Claim Load
    ServiceFacilityAddress
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityAddress
    Data Aggregation Medical Claim Load
    ServiceFacilityAddress
    CLM_VALUES_3.SVC_FAC_ADDR_1
    CLM_VALUES_3.SVC_FAC_ADDR_2

    If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2

    Externally Adjudicated Medical Claim Load
    ServiceFacilityAddress
    CLM_VALUES_3.SVC_FAC_ADDR_1
    CLM_VALUES_3.SVC_FAC_ADDR_2

    If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2

    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityAddress

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityAddress
    CLM_VALUES_3.SVC_FAC_ADDR_1
    CLM_VALUES_3.SVC_FAC_ADDR_2

    If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2

    Received Claim Load
    ServiceFacilityAddress
    CLM_VALUES_3.SVC_FAC_ADDR_1
    CLM_VALUES_3.SVC_FAC_ADDR_2

    If SVC_FAC_ADDR_1 is NULL then SVC_FAC_ADDR_2 Otherwise if SVC_FAC_ADDR_2 is NULL then SVC_FAC_ADDR_1 Otherwise SVC_FAC_ADDR_1 + " " + SVC_FAC_ADDR_2

    Received Pharmacy Claim Load
    ServiceFacilityAddress

    "*Not Applicable"

    ServiceFacilityCity

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityCity
    CMS ACO Part B DME File Load
    ServiceFacilityCity
    CMS ACO Part B Physicians File Load
    ServiceFacilityCity
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityCity
    CMS CJR DME Claim Load
    ServiceFacilityCity
    CMS CJR Home Health Claim Load
    ServiceFacilityCity
    CMS CJR Hospice Claim Load
    ServiceFacilityCity
    CMS CJR Inpatient Claim Load
    ServiceFacilityCity
    CMS CJR Outpatient Claim Load
    ServiceFacilityCity
    CMS CJR Part B Claim Load
    ServiceFacilityCity
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityCity
    Data Aggregation Medical Claim Load
    ServiceFacilityCity
    CLM_VALUES_3.SVC_FAC_CITY
    Externally Adjudicated Medical Claim Load
    ServiceFacilityCity
    CLM_VALUES_3.SVC_FAC_CITY
    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityCity

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityCity
    CLM_VALUES_3.SVC_FAC_CITY
    Received Claim Load
    ServiceFacilityCity
    CLM_VALUES_3.SVC_FAC_CITY
    Received Pharmacy Claim Load
    ServiceFacilityCity

    "*Not Applicable"

    ServiceFacilityStateOrProvince

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityStateOrProvince
    CMS ACO Part B DME File Load
    ServiceFacilityStateOrProvince
    CMS ACO Part B Physicians File Load
    ServiceFacilityStateOrProvince
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityStateOrProvince
    CMS CJR DME Claim Load
    ServiceFacilityStateOrProvince
    CMS CJR Home Health Claim Load
    ServiceFacilityStateOrProvince
    CMS CJR Hospice Claim Load
    ServiceFacilityStateOrProvince
    CMS CJR Inpatient Claim Load
    ServiceFacilityStateOrProvince
    CMS CJR Outpatient Claim Load
    ServiceFacilityStateOrProvince
    CMS CJR Part B Claim Load
    ServiceFacilityStateOrProvince
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityStateOrProvince
    Data Aggregation Medical Claim Load
    ServiceFacilityStateOrProvince
    CLM_VALUES_3.SVC_FAC_STATE
    Externally Adjudicated Medical Claim Load
    ServiceFacilityStateOrProvince
    CLM_VALUES_3.SVC_FAC_STATE
    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityStateOrProvince

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityStateOrProvince
    CLM_VALUES_3.SVC_FAC_STATE
    Received Claim Load
    ServiceFacilityStateOrProvince
    CLM_VALUES_3.SVC_FAC_STATE
    Received Pharmacy Claim Load
    ServiceFacilityStateOrProvince

    "*Not Applicable"

    ServiceFacilityPostalCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityPostalCode
    CMS ACO Part B DME File Load
    ServiceFacilityPostalCode
    CMS ACO Part B Physicians File Load
    ServiceFacilityPostalCode
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityPostalCode
    CMS CJR DME Claim Load
    ServiceFacilityPostalCode
    CMS CJR Home Health Claim Load
    ServiceFacilityPostalCode
    CMS CJR Hospice Claim Load
    ServiceFacilityPostalCode
    CMS CJR Inpatient Claim Load
    ServiceFacilityPostalCode
    CMS CJR Outpatient Claim Load
    ServiceFacilityPostalCode
    CMS CJR Part B Claim Load
    ServiceFacilityPostalCode
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityPostalCode
    Data Aggregation Medical Claim Load
    ServiceFacilityPostalCode
    CLM_VALUES_3.SVC_FAC_ZIP
    Externally Adjudicated Medical Claim Load
    ServiceFacilityPostalCode
    CLM_VALUES_3.SVC_FAC_ZIP
    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityPostalCode

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityPostalCode
    CLM_VALUES_3.SVC_FAC_ZIP
    Received Claim Load
    ServiceFacilityPostalCode
    CLM_VALUES_3.SVC_FAC_ZIP
    Received Pharmacy Claim Load
    ServiceFacilityPostalCode

    "*Not Applicable"

    ServiceFacilityCountry

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceFacilityCountry
    CMS ACO Part B DME File Load
    ServiceFacilityCountry
    CMS ACO Part B Physicians File Load
    ServiceFacilityCountry
    CMS ACO Part D Prescription Drug File Load
    ServiceFacilityCountry
    CMS CJR DME Claim Load
    ServiceFacilityCountry
    CMS CJR Home Health Claim Load
    ServiceFacilityCountry
    CMS CJR Hospice Claim Load
    ServiceFacilityCountry
    CMS CJR Inpatient Claim Load
    ServiceFacilityCountry
    CMS CJR Outpatient Claim Load
    ServiceFacilityCountry
    CMS CJR Part B Claim Load
    ServiceFacilityCountry
    CMS CJR Skilled Nursing Facility Claim Load
    ServiceFacilityCountry
    Data Aggregation Medical Claim Load
    ServiceFacilityCountry
    CLM_VALUES_3.SVC_FAC_CNTRY
    Externally Adjudicated Medical Claim Load
    ServiceFacilityCountry
    CLM_VALUES_3.SVC_FAC_CNTRY
    Externally Adjudicated Pharmacy Claim Load
    ServiceFacilityCountry

    "*Not Applicable"

    Payer System Medical Claim Load
    ServiceFacilityCountry
    CLM_VALUES_3.SVC_FAC_CNTRY
    Received Claim Load
    ServiceFacilityCountry
    CLM_VALUES_3.SVC_FAC_CNTRY
    Received Pharmacy Claim Load
    ServiceFacilityCountry

    "*Not Applicable"

    ServiceClassContext

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceClassContext

    *Not Applicable

    CMS ACO Part B DME File Load
    ServiceClassContext

    *Not Applicable

    CMS ACO Part B Physicians File Load
    ServiceClassContext

    *Not Applicable

    CMS ACO Part D Prescription Drug File Load
    ServiceClassContext

    *Not Applicable

    CMS CJR DME Claim Load
    ServiceClassContext

    *Not Applicable

    CMS CJR Home Health Claim Load
    ServiceClassContext

    *Not Applicable

    CMS CJR Hospice Claim Load
    ServiceClassContext

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ServiceClassContext

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ServiceClassContext

    *Not Applicable

    CMS CJR Part B Claim Load
    ServiceClassContext

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceClassContext

    *Not Applicable

    Data Aggregation Medical Claim Load
    ServiceClassContext
    AP_CLAIM_3.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME
    Data Aggregation Pharmacy Claim Load
    ServiceClassContext
    AP_CLM_RX_2.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME

    The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    Externally Adjudicated Medical Claim Load
    ServiceClassContext
    AP_CLAIM_3.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME
    Externally Adjudicated Pharmacy Claim Load
    ServiceClassContext
    AP_CLM_RX_2.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME

    The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    Payer System Medical Claim Load
    ServiceClassContext
    AP_CLAIM_3.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME
    Payer System Pharmacy Claim Load
    ServiceClassContext
    AP_CLM_RX_2.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME

    The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    Received Claim Load
    ServiceClassContext
    AP_CLAIM_3.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME

    If AP_CLAIM_3.CLAIM_SVC_CLASS_CTX_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C is NULL then "*Unknown" Otherwise ZC_CLAIM_SVC_CLASS_CTX.NAME

    Received Pharmacy Claim Load
    ServiceClassContext
    AP_CLM_RX_2.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.CLAIM_SVC_CLASS_CTX_C
    ZC_CLAIM_SVC_CLASS_CTX.NAME

    The context of the service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    ServiceClass

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceClass

    *Not Applicable

    CMS ACO Part B DME File Load
    ServiceClass

    *Not Applicable

    CMS ACO Part B Physicians File Load
    ServiceClass

    *Not Applicable

    CMS ACO Part D Prescription Drug File Load
    ServiceClass

    *Not Applicable

    CMS CJR DME Claim Load
    ServiceClass

    *Not Applicable

    CMS CJR Home Health Claim Load
    ServiceClass

    *Not Applicable

    CMS CJR Hospice Claim Load
    ServiceClass

    *Not Applicable

    CMS CJR Inpatient Claim Load
    ServiceClass

    *Not Applicable

    CMS CJR Outpatient Claim Load
    ServiceClass

    *Not Applicable

    CMS CJR Part B Claim Load
    ServiceClass

    *Not Applicable

    CMS CJR Skilled Nursing Facility Claim Load
    ServiceClass

    *Not Applicable

    Data Aggregation Medical Claim Load
    ServiceClass
    AP_CLAIM_3.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME
    Data Aggregation Pharmacy Claim Load
    ServiceClass
    AP_CLM_RX_2.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME

    The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    Externally Adjudicated Medical Claim Load
    ServiceClass
    AP_CLAIM_3.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME
    Externally Adjudicated Pharmacy Claim Load
    ServiceClass
    AP_CLM_RX_2.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME

    The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    Payer System Medical Claim Load
    ServiceClass
    AP_CLAIM_3.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME
    Payer System Pharmacy Claim Load
    ServiceClass
    AP_CLM_RX_2.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME

    The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    Received Claim Load
    ServiceClass
    AP_CLAIM_3.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME

    If AP_CLAIM_3.CLAIM_SVC_CLASS_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C is NULL then "*Unknown" Otherwise ZC_CLAIM_SVC_CLASS.NAME

    Received Pharmacy Claim Load
    ServiceClass
    AP_CLM_RX_2.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.CLAIM_SVC_CLASS_C
    ZC_CLAIM_SVC_CLASS.NAME

    The service classification for this claim, based on the Claim Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.

    ClaimEpicId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,0)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ClaimEpicId

    NULL

    CMS ACO Part B DME File Load
    ClaimEpicId

    NULL

    CMS ACO Part B Physicians File Load
    ClaimEpicId

    NULL

    CMS ACO Part D Prescription Drug File Load
    ClaimEpicId

    NULL

    CMS CJR DME Claim Load
    ClaimEpicId

    NULL

    CMS CJR Home Health Claim Load
    ClaimEpicId

    NULL

    CMS CJR Hospice Claim Load
    ClaimEpicId

    NULL

    CMS CJR Inpatient Claim Load
    ClaimEpicId

    NULL

    CMS CJR Outpatient Claim Load
    ClaimEpicId

    NULL

    CMS CJR Part B Claim Load
    ClaimEpicId

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ClaimEpicId

    NULL

    Data Aggregation Medical Claim Load
    ClaimEpicId
    AP_CLAIM.CLAIM_ID
    Data Aggregation Pharmacy Claim Load
    ClaimEpicId
    AP_CLM_RX.CLAIM_ID
    Externally Adjudicated Medical Claim Load
    ClaimEpicId
    AP_CLAIM.CLAIM_ID
    Externally Adjudicated Pharmacy Claim Load
    ClaimEpicId
    AP_CLM_RX.CLAIM_ID
    Payer System Medical Claim Load
    ClaimEpicId
    AP_CLAIM.CLAIM_ID
    Payer System Pharmacy Claim Load
    ClaimEpicId
    AP_CLM_RX.CLAIM_ID
    Received Claim Load
    ClaimEpicId
    AP_CLAIM.CLAIM_ID
    Received Pharmacy Claim Load
    ClaimEpicId
    AP_CLM_RX.CLAIM_ID

    ClaimSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ClaimSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ClaimSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ClaimSpecialty

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    ClaimSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Load
    ClaimSpecialty

    NULL

    CMS CJR Home Health Claim Load
    ClaimSpecialty

    NULL

    CMS CJR Hospice Claim Load
    ClaimSpecialty

    NULL

    CMS CJR Inpatient Claim Load
    ClaimSpecialty

    NULL

    CMS CJR Outpatient Claim Load
    ClaimSpecialty

    NULL

    CMS CJR Part B Claim Load
    ClaimSpecialty

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ClaimSpecialty

    NULL

    Data Aggregation Pharmacy Claim Load
    ClaimSpecialty

    "*Unspecified"

    Externally Adjudicated Medical Claim Load
    ClaimSpecialty

    "*Unspecified"

    Externally Adjudicated Pharmacy Claim Load
    ClaimSpecialty

    "*Unspecified"

    Payer System Pharmacy Claim Load
    ClaimSpecialty

    "*Unspecified"

    Received Claim Load
    ClaimSpecialty
    AP_CLAIM.ASSOC_SPEC_C
    ZC_SPECIALTY.NAME
    ZC_SPECIALTY.SPECIALTY_C

    If AP_CLAIM.ASSOC_SPEC_C is NULL then "*Unspecified" Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then "*Unknown" Otherwise ZC_SPECIALTY.NAME

    Received Pharmacy Claim Load
    ClaimSpecialty

    "*Unspecified"

    DaysCleanDeniedLate

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    int
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DaysCleanDeniedLate

    NULL

    CMS ACO Part B DME File Load
    DaysCleanDeniedLate

    NULL

    CMS ACO Part B Physicians File Load
    DaysCleanDeniedLate

    NULL

    CMS ACO Part D Prescription Drug File Load
    DaysCleanDeniedLate

    NULL

    CMS CJR DME Claim Load
    DaysCleanDeniedLate

    NULL

    CMS CJR Home Health Claim Load
    DaysCleanDeniedLate

    NULL

    CMS CJR Hospice Claim Load
    DaysCleanDeniedLate

    NULL

    CMS CJR Inpatient Claim Load
    DaysCleanDeniedLate

    NULL

    CMS CJR Outpatient Claim Load
    DaysCleanDeniedLate

    NULL

    CMS CJR Part B Claim Load
    DaysCleanDeniedLate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    DaysCleanDeniedLate

    NULL

    Received Claim Load
    DaysCleanDeniedLate
    AP_CLAIM.PAY_BY_DATE
    AP_CLAIM.STATUS_C
    AP_CLAIM.STATUS_DATE
    AP_CLAIM_MILESTONES.TARGET_DATE

    If AP_CLAIM.STATUS_C is 3 or 4 and AP_CLAIM.STATUS_DATE > PaymentDueDate then AP_CLAIM.STATUS_DATE - PaymentDueDate

    DaysPaidLate

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    int
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DaysPaidLate

    NULL

    CMS ACO Part B DME File Load
    DaysPaidLate

    NULL

    CMS ACO Part B Physicians File Load
    DaysPaidLate

    NULL

    CMS ACO Part D Prescription Drug File Load
    DaysPaidLate

    NULL

    CMS CJR DME Claim Load
    DaysPaidLate

    NULL

    CMS CJR Home Health Claim Load
    DaysPaidLate

    NULL

    CMS CJR Hospice Claim Load
    DaysPaidLate

    NULL

    CMS CJR Inpatient Claim Load
    DaysPaidLate

    NULL

    CMS CJR Outpatient Claim Load
    DaysPaidLate

    NULL

    CMS CJR Part B Claim Load
    DaysPaidLate

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    DaysPaidLate

    NULL

    Received Claim Load
    DaysPaidLate
    AP_CHECK.POST_DATE
    AP_CLAIM.PAY_BY_DATE
    AP_CLAIM_2.PAID_CHECK_ID
    AP_CLAIM_MILESTONES.TARGET_DATE

    If AP_CHECK.POST_DATE > PaymentDueDate then AP_CHECK.POST_DATE - PaymentDueDate

    DaysToPay

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    int
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DaysToPay

    NULL

    CMS ACO Part B DME File Load
    DaysToPay

    NULL

    CMS ACO Part B Physicians File Load
    DaysToPay

    NULL

    CMS ACO Part D Prescription Drug File Load
    DaysToPay

    NULL

    CMS CJR DME Claim Load
    DaysToPay

    NULL

    CMS CJR Home Health Claim Load
    DaysToPay

    NULL

    CMS CJR Hospice Claim Load
    DaysToPay

    NULL

    CMS CJR Inpatient Claim Load
    DaysToPay

    NULL

    CMS CJR Outpatient Claim Load
    DaysToPay

    NULL

    CMS CJR Part B Claim Load
    DaysToPay

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    DaysToPay

    NULL

    Received Claim Load
    DaysToPay
    AP_CHECK.POST_DATE
    AP_CLAIM.DATE_RECEIVED

    If POST_DATE is not NULL then POST_DATE - DATE_RECEIVED Otherwise NULL

    EntryMethod

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    EntryMethod

    "*Not Applicable"

    CMS ACO Part B DME File Load
    EntryMethod

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    EntryMethod

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    EntryMethod

    "*Not Applicable"

    CMS CJR DME Claim Load
    EntryMethod

    NULL

    CMS CJR Home Health Claim Load
    EntryMethod

    NULL

    CMS CJR Hospice Claim Load
    EntryMethod

    NULL

    CMS CJR Inpatient Claim Load
    EntryMethod

    NULL

    CMS CJR Outpatient Claim Load
    EntryMethod

    NULL

    CMS CJR Part B Claim Load
    EntryMethod

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    EntryMethod

    NULL

    Data Aggregation Medical Claim Load
    EntryMethod
    AP_CLAIM.EDI_INFO
    AP_CLAIM_2.FROM_OCR_YN

    "Chronicles Claims Loader"

    Data Aggregation Pharmacy Claim Load
    EntryMethod

    "Chronicles Claims Loader"

    Externally Adjudicated Medical Claim Load
    EntryMethod
    AP_CLAIM.EDI_INFO
    AP_CLAIM_2.FROM_OCR_YN

    "EDI"

    Externally Adjudicated Pharmacy Claim Load
    EntryMethod
    AP_CLM_RX.WORKFLOW_C

    If WORKFLOW_C IN ( 4, 5, 8 ) then "EDI" Otherwise "Manual"

    Payer System Medical Claim Load
    EntryMethod
    AP_CLAIM.EDI_INFO
    AP_CLAIM_2.FROM_OCR_YN

    "Chronicles Claims Loader"

    Payer System Pharmacy Claim Load
    EntryMethod

    "Chronicles Claims Loader"

    Received Claim Load
    EntryMethod
    AP_CLAIM.EDI_INFO
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.FROM_OCR_YN

    If AP_CLAIM.WORKFLOW_C = 8 then "EDI" Otherwise if AP_CLAIM.EDI_INFO is not NULL then "EDI" Otherwise if AP_CLAIM_2.FROM_OCR_YN = Y then "OCR" Otherwise if AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then "EDI" Otherwise "Manual"

    Received Pharmacy Claim Load
    EntryMethod
    AP_CLM_RX.WORKFLOW_C

    If WORKFLOW_C IN ( 4, 5, 8 ) then "EDI" Otherwise "Manual"

    LineOfBusinessName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    LineOfBusinessName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    LineOfBusinessName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    LineOfBusinessName

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    LineOfBusinessName

    "*Not Applicable"

    CMS CJR DME Claim Load
    LineOfBusinessName

    NULL

    CMS CJR Home Health Claim Load
    LineOfBusinessName

    NULL

    CMS CJR Hospice Claim Load
    LineOfBusinessName

    NULL

    CMS CJR Inpatient Claim Load
    LineOfBusinessName

    NULL

    CMS CJR Outpatient Claim Load
    LineOfBusinessName

    NULL

    CMS CJR Part B Claim Load
    LineOfBusinessName

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    LineOfBusinessName

    NULL

    Data Aggregation Medical Claim Load
    LineOfBusinessName
    CLM_VALUES_5.LINE_OF_BUSINESS_NAME
    Data Aggregation Pharmacy Claim Load
    LineOfBusinessName
    CLM_VALUES_5.LINE_OF_BUSINESS_NAME
    Externally Adjudicated Medical Claim Load
    LineOfBusinessName
    AP_CLAIM.CLM_LOB_ID
    CLARITY_LOB.LOB_NAME

    If CLARITY_LOB.LOB_NAME is not NULL then CLARITY_LOB.LOB_NAME Otherwise if AP_CLAIM.CLM_LOB_ID is NULL then "*Unspecified" Otherwise "*Unknown"

    Externally Adjudicated Pharmacy Claim Load
    LineOfBusinessName

    "*Unspecified"

    Payer System Medical Claim Load
    LineOfBusinessName
    CLM_VALUES_5.LINE_OF_BUSINESS_NAME
    Payer System Pharmacy Claim Load
    LineOfBusinessName
    CLM_VALUES_5.LINE_OF_BUSINESS_NAME
    Received Claim Load
    LineOfBusinessName
    AP_CLAIM.CLM_LOB_ID
    CLARITY_LOB.LOB_NAME

    If LOB_NAME is not NULL then LOB_NAME Otherwise if CLM_LOB_ID is NULL then "*Unspecified" Otherwise "*Unknown"

    Received Pharmacy Claim Load
    LineOfBusinessName

    "*Unspecified"

    LineOfBusinessEpicId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    LineOfBusinessEpicId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    CMS ACO Part B DME File Load
    LineOfBusinessEpicId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    CMS ACO Part B Physicians File Load
    LineOfBusinessEpicId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    CMS ACO Part D Prescription Drug File Load
    LineOfBusinessEpicId
    Epic.ConfigurationInfo_PlanAttributeConfiguration.LineOfBusinessDefaultId

    Line of business as configured through interface configuration in Chronicles

    CMS CJR DME Claim Load
    LineOfBusinessEpicId

    NULL

    CMS CJR Home Health Claim Load
    LineOfBusinessEpicId

    NULL

    CMS CJR Hospice Claim Load
    LineOfBusinessEpicId

    NULL

    CMS CJR Inpatient Claim Load
    LineOfBusinessEpicId

    NULL

    CMS CJR Outpatient Claim Load
    LineOfBusinessEpicId

    NULL

    CMS CJR Part B Claim Load
    LineOfBusinessEpicId

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    LineOfBusinessEpicId

    NULL

    Data Aggregation Medical Claim Load
    LineOfBusinessEpicId
    AP_CLAIM.CLM_LOB_ID
    Data Aggregation Pharmacy Claim Load
    LineOfBusinessEpicId
    AP_CLM_RX_2.CLM_LOB_ID
    Externally Adjudicated Medical Claim Load
    LineOfBusinessEpicId
    AP_CLAIM.CLM_LOB_ID
    Externally Adjudicated Pharmacy Claim Load
    LineOfBusinessEpicId

    "*Unspecified"

    Payer System Medical Claim Load
    LineOfBusinessEpicId
    AP_CLAIM.CLM_LOB_ID
    Payer System Pharmacy Claim Load
    LineOfBusinessEpicId
    AP_CLM_RX_2.CLM_LOB_ID
    Received Claim Load
    LineOfBusinessEpicId
    AP_CLAIM.CLM_LOB_ID
    Received Pharmacy Claim Load
    LineOfBusinessEpicId

    "*Unspecified"

    NetworkLevel

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    NetworkLevel

    "*Not Applicable"

    CMS ACO Part B DME File Load
    NetworkLevel

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    NetworkLevel

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    NetworkLevel

    "*Not Applicable"

    CMS CJR DME Claim Load
    NetworkLevel

    NULL

    CMS CJR Home Health Claim Load
    NetworkLevel

    NULL

    CMS CJR Hospice Claim Load
    NetworkLevel

    NULL

    CMS CJR Inpatient Claim Load
    NetworkLevel

    NULL

    CMS CJR Outpatient Claim Load
    NetworkLevel

    NULL

    CMS CJR Part B Claim Load
    NetworkLevel

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    NetworkLevel

    NULL

    Data Aggregation Medical Claim Load
    NetworkLevel
    AP_CLAIM.IN_OUT_NET_C
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME

    If AP_CLAIM.IN_OUT_NET_C is NULL then "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME

    Data Aggregation Pharmacy Claim Load
    NetworkLevel
    AP_CLM_RX_2.IN_OUT_OF_NET_C
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME

    If AP_CLM_RX_2.IN_OUT_OF_NET_C is NULL THEN "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL THEN "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME

    Externally Adjudicated Medical Claim Load
    NetworkLevel
    AP_CLAIM.IN_OUT_NET_C
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME

    If AP_CLAIM.IN_OUT_NET_C is NULL then ''*Unspecified''' Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then ''*Unknown''' Otherwise if ZC_NET_AFFIL_LEVEL.NAME IS NOT NULL THEN ZC_NET_AFFIL_LEVEL.NAME Otherwise ZC_ADJ_NET_STATUS.NAME

    Externally Adjudicated Pharmacy Claim Load
    NetworkLevel
    AP_CLM_RX_2.IN_OUT_OF_NET_C
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME

    If AP_CLM_RX_2.IN_OUT_OF_NET_C is NULL then '*Unspecified' Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then '*Unknown' Otherwise ZC_ADJ_NET_STATUS.NAME

    Payer System Medical Claim Load
    NetworkLevel
    AP_CLAIM.IN_OUT_NET_C
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME

    If AP_CLAIM.IN_OUT_NET_C is NULL then "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME

    Payer System Pharmacy Claim Load
    NetworkLevel
    AP_CLM_RX_2.IN_OUT_OF_NET_C
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME

    If AP_CLM_RX_2.IN_OUT_OF_NET_C is NULL THEN "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL THEN "*Unknown" Otherwise ZC_ADJ_NET_STATUS.NAME

    Received Claim Load
    NetworkLevel
    AP_CLAIM.AJUD_IN_NET_OVRD_C
    AP_CLAIM.IN_OUT_NET_C
    AP_CLAIM_3.OUT_NET_ADJUD_OV_C
    AP_CLAIM_4.OVERALL_NETWORK_LEVEL
    ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C
    ZC_ADJ_NET_STATUS.NAME
    ZC_NET_AFFIL_LEVEL.NAME
    ZC_NET_AFFIL_LEVEL.NET_AFFIL_LEVEL_C

    If OVERALL_NETWORK_LEVEL is not NULL then OVERALL_NETWORK_LEVEL Otherwise if OUT_NET_ADJUD_OV_C is not NULL and ZC_ADJ_NET_STATUS.NAME is null where ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C = 2 - Out of Network THEN "*Unknown" Otherwise if OUT_NET_ADJUD_OV_C is not NULL then ZC_ADJ_NET_STATUS.NAME where ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C = 2 - Out of Network Otherwise if AP_CLAIM.IN_OUT_NET_C is NULL then "*Unspecified" Otherwise if ZC_ADJ_NET_STATUS.ADJ_NET_STATUS_C is NULL then "*Unknown" Otherwise if ZC_NET_AFFIL_LEVEL.NAME is not NULL then ZC_NET_AFFIL_LEVEL.NAME Otherwise ZC_ADJ_NET_STATUS.NAME

    Received Pharmacy Claim Load
    NetworkLevel

    "*Unspecified"

    ProcessingStatus

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ProcessingStatus
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    MsspPartAClaimsHeader.CLM_MDCR_NPMT_RSN_CD

    If CLM_MDCR_NPMT_RSN_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unspecified" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean"

    CMS ACO Part B DME File Load
    ProcessingStatus
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    MsspPartBDme.CLM_CARR_PMT_DNL_CD

    If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unspecified" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean"

    CMS ACO Part B Physicians File Load
    ProcessingStatus
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    MsspPartBPhysicians.CLM_CARR_PMT_DNL_CD

    If CLM_CARR_PMT_DNL_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimCarrierPaymentDenialCode" then "*Unspecified" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean"

    CMS ACO Part D Prescription Drug File Load
    ProcessingStatus

    "*Not Applicable"

    CMS CJR DME Claim Load
    ProcessingStatus

    NULL

    CMS CJR Home Health Claim Load
    ProcessingStatus

    NULL

    CMS CJR Hospice Claim Load
    ProcessingStatus

    NULL

    CMS CJR Inpatient Claim Load
    ProcessingStatus

    NULL

    CMS CJR Outpatient Claim Load
    ProcessingStatus

    NULL

    CMS CJR Part B Claim Load
    ProcessingStatus

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ProcessingStatus

    NULL

    Data Aggregation Medical Claim Load
    ProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Data Aggregation Pharmacy Claim Load
    ProcessingStatus
    AP_CLM_RX.CLM_STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    Externally Adjudicated Medical Claim Load
    ProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Externally Adjudicated Pharmacy Claim Load
    ProcessingStatus
    AP_CLM_RX.CLM_STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    Payer System Medical Claim Load
    ProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Payer System Pharmacy Claim Load
    ProcessingStatus
    AP_CLM_RX.CLM_STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    Received Claim Load
    ProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Received Pharmacy Claim Load
    ProcessingStatus
    AP_CLM_RX.CLM_STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    PaymentStatus

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PaymentStatus

    "*Not Applicable"

    CMS ACO Part B DME File Load
    PaymentStatus

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    PaymentStatus

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    PaymentStatus

    "*Not Applicable"

    CMS CJR DME Claim Load
    PaymentStatus

    NULL

    CMS CJR Home Health Claim Load
    PaymentStatus

    NULL

    CMS CJR Hospice Claim Load
    PaymentStatus

    NULL

    CMS CJR Inpatient Claim Load
    PaymentStatus

    NULL

    CMS CJR Outpatient Claim Load
    PaymentStatus

    NULL

    CMS CJR Part B Claim Load
    PaymentStatus

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    PaymentStatus

    NULL

    Received Claim Load
    PaymentStatus
    AP_CLAIM.AP_STS_C
    ZC_CLM_AP_STAT.AP_STS_C
    ZC_CLM_AP_STAT.NAME

    If AP_CLAIM.AP_STS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_AP_STAT.AP_STS_C is NULL then "*Unknown" Otherwise ZC_CLM_AP_STAT.NAME

    TaxIdNumber

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TaxIdNumber

    "*Not Applicable"

    CMS ACO Part B DME File Load
    TaxIdNumber

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    TaxIdNumber
    MsspPartBPhysicians.CLM_RNDRG_PRVDR_TAX_NUM

    If CLM_RNDRG_PRVDR_TAX_NUM is the same across all CLM_LINE_NUM values with the same CUR_CLM_UNIQ_ID then CLM_RNDRG_PRVDR_TAX_NUM, otherwise "*Unspecified"

    CMS ACO Part D Prescription Drug File Load
    TaxIdNumber
    MsspPartD.CLM_PRSBNG_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_PRSBNG_ID_QLFYR_CD

    If PRVDR_PRSBNG_ID_QLFYR_CD = 11-TIN then CLM_PRSBNG_PRVDR_GNRC_ID_NUM Otherwise "*Unspecified"

    CMS CJR DME Claim Load
    TaxIdNumber

    NULL

    CMS CJR Home Health Claim Load
    TaxIdNumber

    NULL

    CMS CJR Hospice Claim Load
    TaxIdNumber

    NULL

    CMS CJR Inpatient Claim Load
    TaxIdNumber

    NULL

    CMS CJR Outpatient Claim Load
    TaxIdNumber

    NULL

    CMS CJR Part B Claim Load
    TaxIdNumber

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TaxIdNumber

    NULL

    Data Aggregation Medical Claim Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Data Aggregation Pharmacy Claim Load
    TaxIdNumber
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    Externally Adjudicated Medical Claim Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Externally Adjudicated Pharmacy Claim Load
    TaxIdNumber
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    Payer System Medical Claim Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Payer System Pharmacy Claim Load
    TaxIdNumber
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    Received Claim Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Received Pharmacy Claim Load
    TaxIdNumber
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT
    CLM_VALUES_SVC_PROV_ID.SVC_PROV_IDENT_QUAL

    If SVC_PROV_IDENT_QUAL = "11" and SVC_PROV_IDENT is not NULL then SVC_PROV_IDENT Otherwise NULL

    CliaCertificationNumber

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS ACO Part B DME File Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR DME Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR Home Health Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR Hospice Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR Inpatient Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR Outpatient Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR Part B Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    CMS CJR Skilled Nursing Facility Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    Data Aggregation Medical Claim Load
    CliaCertificationNumber
    AP_CLAIM_3.CLIA_NUMBER
    CLM_VALUES_2.CLIA_NUM

    If CLIA_NUM is not NULL then CLIA_NUM Otherwise CLIA_NUMBER

    Data Aggregation Pharmacy Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    Externally Adjudicated Medical Claim Load
    CliaCertificationNumber
    AP_CLAIM_3.CLIA_NUMBER
    CLM_VALUES_2.CLIA_NUM

    If CLIA_NUM is not NULL THEN CLIA_NUM Otherwise CLIA_NUMBER

    Externally Adjudicated Pharmacy Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    Payer System Medical Claim Load
    CliaCertificationNumber
    AP_CLAIM_3.CLIA_NUMBER
    CLM_VALUES_2.CLIA_NUM

    If CLIA_NUM is not NULL THEN CLIA_NUM Otherwise CLIA_NUMBER

    Payer System Pharmacy Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    Received Claim Load
    CliaCertificationNumber
    AP_CLAIM_3.CLIA_NUMBER
    CLM_VALUES_2.CLIA_NUM

    If CLIA_NUM is not NULL THEN CLIA_NUM Otherwise CLIA_NUMBER

    Received Pharmacy Claim Load
    CliaCertificationNumber

    "*Not Applicable"

    TypeOfBillFacilityTypeCode

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS ACO Part B DME File Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS ACO Part B Physicians File Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS ACO Part D Prescription Drug File Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR DME Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Home Health Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Hospice Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Inpatient Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Outpatient Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Part B Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    Data Aggregation Medical Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    Externally Adjudicated Medical Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    Payer System Medical Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    Received Claim Load
    TypeOfBillFacilityTypeCode

    NULL

    TypeOfBillServiceTypeCode

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillServiceTypeCode

    NULL

    CMS ACO Part B DME File Load
    TypeOfBillServiceTypeCode

    NULL

    CMS ACO Part B Physicians File Load
    TypeOfBillServiceTypeCode

    NULL

    CMS ACO Part D Prescription Drug File Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR DME Claim Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Home Health Claim Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Hospice Claim Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Inpatient Claim Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Outpatient Claim Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Part B Claim Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TypeOfBillServiceTypeCode

    NULL

    Data Aggregation Medical Claim Load
    TypeOfBillServiceTypeCode

    NULL

    Externally Adjudicated Medical Claim Load
    TypeOfBillServiceTypeCode

    NULL

    Payer System Medical Claim Load
    TypeOfBillServiceTypeCode

    NULL

    Received Claim Load
    TypeOfBillServiceTypeCode

    NULL

    TypeOfBillFrequencyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillFrequencyCode

    NULL

    CMS ACO Part B DME File Load
    TypeOfBillFrequencyCode

    NULL

    CMS ACO Part B Physicians File Load
    TypeOfBillFrequencyCode

    NULL

    CMS ACO Part D Prescription Drug File Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR DME Claim Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Home Health Claim Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Hospice Claim Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Inpatient Claim Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Outpatient Claim Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Part B Claim Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TypeOfBillFrequencyCode

    NULL

    Data Aggregation Medical Claim Load
    TypeOfBillFrequencyCode

    NULL

    Externally Adjudicated Medical Claim Load
    TypeOfBillFrequencyCode

    NULL

    Payer System Medical Claim Load
    TypeOfBillFrequencyCode

    NULL

    Received Claim Load
    TypeOfBillFrequencyCode

    NULL

    VendorRelationship

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    VendorRelationship

    "*Not Applicable"

    CMS ACO Part B DME File Load
    VendorRelationship

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    VendorRelationship

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    VendorRelationship

    "*Not Applicable"

    CMS CJR DME Claim Load
    VendorRelationship

    NULL

    CMS CJR Home Health Claim Load
    VendorRelationship

    NULL

    CMS CJR Hospice Claim Load
    VendorRelationship

    NULL

    CMS CJR Inpatient Claim Load
    VendorRelationship

    NULL

    CMS CJR Outpatient Claim Load
    VendorRelationship

    NULL

    CMS CJR Part B Claim Load
    VendorRelationship

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    VendorRelationship

    NULL

    Externally Adjudicated Medical Claim Load
    VendorRelationship

    NULL

    Received Claim Load
    VendorRelationship
    AP_CLAIM_3.INT_EXT_C
    ZC_INT_EXT.INT_EXT_C
    ZC_INT_EXT.NAME

    If AP_CLAIM_3.INT_EXT_C is NULL then "*Unspecified" Otherwise if ZC_INT_EXT.INT_EXT_C is NULL then "*Unknown" Otherwise ZC_INT_EXT.NAME

    Workflow

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    Workflow

    "*Not Applicable"

    CMS ACO Part B DME File Load
    Workflow

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    Workflow

    "*Not Applicable"

    CMS ACO Part D Prescription Drug File Load
    Workflow

    "*Not Applicable"

    CMS CJR DME Claim Load
    Workflow

    NULL

    CMS CJR Home Health Claim Load
    Workflow

    NULL

    CMS CJR Hospice Claim Load
    Workflow

    NULL

    CMS CJR Inpatient Claim Load
    Workflow

    NULL

    CMS CJR Outpatient Claim Load
    Workflow

    NULL

    CMS CJR Part B Claim Load
    Workflow

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    Workflow

    NULL

    Data Aggregation Medical Claim Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Data Aggregation Pharmacy Claim Load
    Workflow
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C
    Externally Adjudicated Medical Claim Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Externally Adjudicated Pharmacy Claim Load
    Workflow
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C
    Payer System Medical Claim Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Payer System Pharmacy Claim Load
    Workflow
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C
    Received Claim Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Received Pharmacy Claim Load
    Workflow
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    TotalBilledAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalBilledAmount
    MsspPartAClaimsHeader.CLM_MDCR_INSTNL_TOT_CHRG_AMT

    NULL

    CMS ACO Part B DME File Load
    TotalBilledAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalBilledAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalBilledAmount

    NULL

    CMS CJR DME Claim Load
    TotalBilledAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalBilledAmount
    CmsCjrHomeHealthHeader.TOT_CHRG
    CMS CJR Hospice Claim Load
    TotalBilledAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalBilledAmount
    CmsCjrInpatientHeader.CHARGAMT
    CMS CJR Outpatient Claim Load
    TotalBilledAmount

    NULL

    CMS CJR Part B Claim Load
    TotalBilledAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalBilledAmount
    CmsCjrSkilledNursingHeader.CHARGAMT
    Data Aggregation Medical Claim Load
    TotalBilledAmount
    AP_CLAIM.TOT_BILLED_AMT
    Data Aggregation Pharmacy Claim Load
    TotalBilledAmount
    AP_CLM_RX.TTL_BILLED
    Externally Adjudicated Medical Claim Load
    TotalBilledAmount
    AP_CLAIM.TOT_BILLED_AMT
    Externally Adjudicated Pharmacy Claim Load
    TotalBilledAmount
    AP_CLM_RX.TTL_BILLED
    Payer System Medical Claim Load
    TotalBilledAmount
    AP_CLAIM.TOT_BILLED_AMT
    Payer System Pharmacy Claim Load
    TotalBilledAmount
    AP_CLM_RX.TTL_BILLED
    Received Claim Load
    TotalBilledAmount
    AP_CLAIM.TOT_BILLED_AMT
    Received Pharmacy Claim Load
    TotalBilledAmount
    AP_CLM_RX.TTL_BILLED

    TotalDiscountAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalDiscountAmount

    NULL

    CMS ACO Part B DME File Load
    TotalDiscountAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalDiscountAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalDiscountAmount

    NULL

    CMS CJR DME Claim Load
    TotalDiscountAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalDiscountAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalDiscountAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalDiscountAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalDiscountAmount

    NULL

    CMS CJR Part B Claim Load
    TotalDiscountAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalDiscountAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalDiscountAmount
    AP_CLAIM.TOT_DISCOUNT
    Received Claim Load
    TotalDiscountAmount
    AP_CLAIM.TOT_DISCOUNT

    TotalAllowedAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalAllowedAmount

    NULL

    CMS ACO Part B DME File Load
    TotalAllowedAmount
    MsspPartBDme.CLM_ADJSMT_TYPE_CD
    MsspPartBDme.CLM_LINE_ALOWD_CHRG_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise sum of CLM_LINE_ALOWD_CHRG_AMT

    CMS ACO Part B Physicians File Load
    TotalAllowedAmount
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_LINE_ALOWD_CHRG_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise sum of CLM_LINE_ALOWD_CHRG_AMT

    CMS ACO Part D Prescription Drug File Load
    TotalAllowedAmount

    NULL

    CMS CJR DME Claim Load
    TotalAllowedAmount
    CmsCjrDmeHeader.ALOWCHRG
    CMS CJR Home Health Claim Load
    TotalAllowedAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalAllowedAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalAllowedAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalAllowedAmount

    NULL

    CMS CJR Part B Claim Load
    TotalAllowedAmount
    CmsCjrPartBHeader.ALOWCHRG
    CMS CJR Skilled Nursing Facility Claim Load
    TotalAllowedAmount

    NULL

    Data Aggregation Medical Claim Load
    TotalAllowedAmount
    AP_CLAIM.TOT_ALLOWED_AMT
    Data Aggregation Pharmacy Claim Load
    TotalAllowedAmount
    AP_CLM_RX.TTL_ALLOWED_AMT
    Externally Adjudicated Medical Claim Load
    TotalAllowedAmount
    AP_CLAIM.TOT_ALLOWED_AMT
    Externally Adjudicated Pharmacy Claim Load
    TotalAllowedAmount
    AP_CLM_RX.TTL_ALLOWED_AMT
    Payer System Medical Claim Load
    TotalAllowedAmount
    AP_CLAIM.TOT_ALLOWED_AMT
    Payer System Pharmacy Claim Load
    TotalAllowedAmount
    AP_CLM_RX.TTL_ALLOWED_AMT
    Received Claim Load
    TotalAllowedAmount
    AP_CLAIM.TOT_ALLOWED_AMT
    Received Pharmacy Claim Load
    TotalAllowedAmount
    AP_CLM_RX.TTL_ALLOWED_AMT

    TotalCopayAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalCopayAmount

    NULL

    CMS ACO Part B DME File Load
    TotalCopayAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalCopayAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalCopayAmount

    NULL

    CMS CJR DME Claim Load
    TotalCopayAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalCopayAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalCopayAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalCopayAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalCopayAmount

    NULL

    CMS CJR Part B Claim Load
    TotalCopayAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalCopayAmount

    NULL

    Data Aggregation Medical Claim Load
    TotalCopayAmount
    AP_CLAIM.TOT_COPAY
    Data Aggregation Pharmacy Claim Load
    TotalCopayAmount
    AP_CLM_RX.TTL_COPAY
    Externally Adjudicated Medical Claim Load
    TotalCopayAmount
    AP_CLAIM.TOT_COPAY
    Externally Adjudicated Pharmacy Claim Load
    TotalCopayAmount
    AP_CLM_RX.TTL_COPAY
    Payer System Medical Claim Load
    TotalCopayAmount
    AP_CLAIM.TOT_COPAY
    Payer System Pharmacy Claim Load
    TotalCopayAmount
    AP_CLM_RX.TTL_COPAY
    Received Claim Load
    TotalCopayAmount
    AP_CLAIM.TOT_COPAY
    Received Pharmacy Claim Load
    TotalCopayAmount
    AP_CLM_RX.TTL_COPAY

    TotalCoinsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalCoinsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    TotalCoinsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalCoinsuranceAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalCoinsuranceAmount

    NULL

    CMS CJR DME Claim Load
    TotalCoinsuranceAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalCoinsuranceAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalCoinsuranceAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalCoinsuranceAmount
    CmsCjrInpatientHeader.COIN_AMT
    CMS CJR Outpatient Claim Load
    TotalCoinsuranceAmount

    NULL

    CMS CJR Part B Claim Load
    TotalCoinsuranceAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalCoinsuranceAmount
    CmsCjrSkilledNursingHeader.COIN_AMT
    Data Aggregation Medical Claim Load
    TotalCoinsuranceAmount
    AP_CLAIM.TOT_COINS
    Data Aggregation Pharmacy Claim Load
    TotalCoinsuranceAmount
    AP_CLM_RX.TTL_COINS
    Externally Adjudicated Medical Claim Load
    TotalCoinsuranceAmount
    AP_CLAIM.TOT_COINS
    Externally Adjudicated Pharmacy Claim Load
    TotalCoinsuranceAmount
    AP_CLM_RX.TTL_COINS
    Payer System Medical Claim Load
    TotalCoinsuranceAmount
    AP_CLAIM.TOT_COINS
    Payer System Pharmacy Claim Load
    TotalCoinsuranceAmount
    AP_CLM_RX.TTL_COINS
    Received Claim Load
    TotalCoinsuranceAmount
    AP_CLAIM.TOT_COINS
    Received Pharmacy Claim Load
    TotalCoinsuranceAmount
    AP_CLM_RX.TTL_COINS

    TotalDeductibleAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalDeductibleAmount

    NULL

    CMS ACO Part B DME File Load
    TotalDeductibleAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalDeductibleAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalDeductibleAmount

    NULL

    CMS CJR DME Claim Load
    TotalDeductibleAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalDeductibleAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalDeductibleAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalDeductibleAmount
    CmsCjrInpatientHeader.DED_AMT
    CMS CJR Outpatient Claim Load
    TotalDeductibleAmount

    NULL

    CMS CJR Part B Claim Load
    TotalDeductibleAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalDeductibleAmount
    CmsCjrSkilledNursingHeader.DED_AMT
    Data Aggregation Medical Claim Load
    TotalDeductibleAmount
    AP_CLAIM.TOT_DEDUCTIBLE
    Data Aggregation Pharmacy Claim Load
    TotalDeductibleAmount
    AP_CLM_RX.TTL_DEDUCTIBLE
    Externally Adjudicated Medical Claim Load
    TotalDeductibleAmount
    AP_CLAIM.TOT_DEDUCTIBLE
    Externally Adjudicated Pharmacy Claim Load
    TotalDeductibleAmount
    AP_CLM_RX.TTL_DEDUCTIBLE
    Payer System Medical Claim Load
    TotalDeductibleAmount
    AP_CLAIM.TOT_DEDUCTIBLE
    Payer System Pharmacy Claim Load
    TotalDeductibleAmount
    AP_CLM_RX.TTL_DEDUCTIBLE
    Received Claim Load
    TotalDeductibleAmount
    AP_CLAIM.TOT_DEDUCTIBLE
    Received Pharmacy Claim Load
    TotalDeductibleAmount
    AP_CLM_RX.TTL_DEDUCTIBLE

    TotalNotCoveredAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalNotCoveredAmount

    NULL

    CMS ACO Part B DME File Load
    TotalNotCoveredAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalNotCoveredAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalNotCoveredAmount

    NULL

    CMS CJR DME Claim Load
    TotalNotCoveredAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalNotCoveredAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalNotCoveredAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalNotCoveredAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalNotCoveredAmount

    NULL

    CMS CJR Part B Claim Load
    TotalNotCoveredAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalNotCoveredAmount

    NULL

    Data Aggregation Medical Claim Load
    TotalNotCoveredAmount
    AP_CLAIM.TOT_NOT_COVD_AMT
    Data Aggregation Pharmacy Claim Load
    TotalNotCoveredAmount
    AP_CLM_RX.TOT_NOT_COVERED_AMT
    Externally Adjudicated Medical Claim Load
    TotalNotCoveredAmount
    AP_CLAIM.TOT_NOT_COVD_AMT
    Payer System Medical Claim Load
    TotalNotCoveredAmount
    AP_CLAIM.TOT_NOT_COVD_AMT
    Received Claim Load
    TotalNotCoveredAmount
    AP_CLAIM.TOT_NOT_COVD_AMT

    TotalPatientPortionAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalPatientPortionAmount

    NULL

    CMS ACO Part B DME File Load
    TotalPatientPortionAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalPatientPortionAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalPatientPortionAmount
    MsspPartD.CLM_ADJSMT_TYPE_CD
    MsspPartD.CLM_LINE_BENE_PMT_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_BENE_PMT_AMT × (-1) Otherwise CLM_LINE_BENE_PMT_AMT

    CMS CJR DME Claim Load
    TotalPatientPortionAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalPatientPortionAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalPatientPortionAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalPatientPortionAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalPatientPortionAmount

    NULL

    CMS CJR Part B Claim Load
    TotalPatientPortionAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalPatientPortionAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalPatientPortionAmount
    AP_CLAIM.TOT_PAT_PORTION
    Received Claim Load
    TotalPatientPortionAmount
    AP_CLAIM.TOT_PAT_PORTION

    TotalInsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalInsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    TotalInsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalInsuranceAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalInsuranceAmount

    NULL

    CMS CJR DME Claim Load
    TotalInsuranceAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalInsuranceAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalInsuranceAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalInsuranceAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalInsuranceAmount

    NULL

    CMS CJR Part B Claim Load
    TotalInsuranceAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalInsuranceAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalInsuranceAmount
    AP_CLAIM.TOT_INSURANCE_AMT
    Received Claim Load
    TotalInsuranceAmount
    AP_CLAIM.TOT_INSURANCE_AMT

    TotalAdjustmentAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalAdjustmentAmount

    NULL

    CMS ACO Part B DME File Load
    TotalAdjustmentAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalAdjustmentAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalAdjustmentAmount

    NULL

    CMS CJR DME Claim Load
    TotalAdjustmentAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalAdjustmentAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalAdjustmentAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalAdjustmentAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalAdjustmentAmount

    NULL

    CMS CJR Part B Claim Load
    TotalAdjustmentAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalAdjustmentAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalAdjustmentAmount
    AP_CLAIM.TOT_ADJUSTMENT
    Received Claim Load
    TotalAdjustmentAmount
    AP_CLAIM.TOT_ADJUSTMENT

    TotalNetInsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalNetInsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    TotalNetInsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalNetInsuranceAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR DME Claim Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR Part B Claim Load
    TotalNetInsuranceAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalNetInsuranceAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalNetInsuranceAmount
    AP_CLAIM.TOT_NET_INSURANCE
    Received Claim Load
    TotalNetInsuranceAmount
    AP_CLAIM.TOT_NET_INSURANCE

    TotalExceededBenefitAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalExceededBenefitAmount

    NULL

    CMS ACO Part B DME File Load
    TotalExceededBenefitAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalExceededBenefitAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR DME Claim Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR Part B Claim Load
    TotalExceededBenefitAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalExceededBenefitAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalExceededBenefitAmount
    AP_CLAIM.TOT_EXD_BEN_AMT
    Received Claim Load
    TotalExceededBenefitAmount
    AP_CLAIM.TOT_EXD_BEN_AMT

    TotalWithholdingAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalWithholdingAmount

    NULL

    CMS ACO Part B DME File Load
    TotalWithholdingAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalWithholdingAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalWithholdingAmount

    NULL

    CMS CJR DME Claim Load
    TotalWithholdingAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalWithholdingAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalWithholdingAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalWithholdingAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalWithholdingAmount

    NULL

    CMS CJR Part B Claim Load
    TotalWithholdingAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalWithholdingAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalWithholdingAmount
    AP_CLAIM.TOT_WITHHOLDING
    Received Claim Load
    TotalWithholdingAmount
    AP_CLAIM.TOT_WITHHOLDING

    TotalNetPayableAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalNetPayableAmount
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD
    MsspPartAClaimsHeader.CLM_PMT_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_PMT_AMT × (-1) Otherwise CLM_PMT_AMT

    CMS ACO Part B DME File Load
    TotalNetPayableAmount
    MsspPartBDme.CLM_ADJSMT_TYPE_CD
    MsspPartBDme.CLM_LINE_CVRD_PD_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_CVRD_PD_AMT × (-1) Otherwise sum of CLM_LINE_CVRD_PD_AMT

    CMS ACO Part B Physicians File Load
    TotalNetPayableAmount
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_LINE_CVRD_PD_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then the product of the sum of CLM_LINE_CVRD_PD_AMT × (-1) Otherwise sum of CLM_LINE_CVRD_PD_AMT

    CMS ACO Part D Prescription Drug File Load
    TotalNetPayableAmount

    NULL

    CMS CJR DME Claim Load
    TotalNetPayableAmount
    CmsCJrDmeHeader.PMT_AMT
    CMS CJR Home Health Claim Load
    TotalNetPayableAmount
    CmsCJrHomeHealthHeader.PMT_AMT
    CMS CJR Hospice Claim Load
    TotalNetPayableAmount
    CmsCjrHospiceHeader.PMT_AMT
    CMS CJR Inpatient Claim Load
    TotalNetPayableAmount
    CmsCjrInpatientHeader.PMT_AMT
    CMS CJR Outpatient Claim Load
    TotalNetPayableAmount
    CmsCjrOutpatientHeader.PMT_AMT
    CMS CJR Part B Claim Load
    TotalNetPayableAmount
    CmsCjrPartBHeader.PMT_AMT
    CMS CJR Skilled Nursing Facility Claim Load
    TotalNetPayableAmount
    CmsCjrSkilledNursingHeader.PMT_AMT
    Data Aggregation Medical Claim Load
    TotalNetPayableAmount
    AP_CLAIM.TOT_NET_PAYABLE
    Data Aggregation Pharmacy Claim Load
    TotalNetPayableAmount
    AP_CLM_RX.TTL_NET_PAYABLE
    Externally Adjudicated Medical Claim Load
    TotalNetPayableAmount
    AP_CLAIM.TOT_NET_PAYABLE
    Externally Adjudicated Pharmacy Claim Load
    TotalNetPayableAmount
    AP_CLM_RX.TTL_NET_PAYABLE
    Payer System Medical Claim Load
    TotalNetPayableAmount
    AP_CLAIM.TOT_NET_PAYABLE
    Payer System Pharmacy Claim Load
    TotalNetPayableAmount
    AP_CLM_RX.TTL_NET_PAYABLE
    Received Claim Load
    TotalNetPayableAmount
    AP_CLAIM.TOT_NET_PAYABLE
    Received Pharmacy Claim Load
    TotalNetPayableAmount
    AP_CLM_RX.TTL_NET_PAYABLE

    TotalInterestAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalInterestAmount

    NULL

    CMS ACO Part B DME File Load
    TotalInterestAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalInterestAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalInterestAmount

    NULL

    CMS CJR DME Claim Load
    TotalInterestAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalInterestAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalInterestAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalInterestAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalInterestAmount

    NULL

    CMS CJR Part B Claim Load
    TotalInterestAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalInterestAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalInterestAmount
    AP_CLAIM_2.INTEREST_TOTAL
    Received Claim Load
    TotalInterestAmount
    AP_CLAIM_2.INTEREST_TOTAL

    TotalPenaltyAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalPenaltyAmount

    NULL

    CMS ACO Part B DME File Load
    TotalPenaltyAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalPenaltyAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalPenaltyAmount

    NULL

    CMS CJR DME Claim Load
    TotalPenaltyAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalPenaltyAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalPenaltyAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalPenaltyAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalPenaltyAmount

    NULL

    CMS CJR Part B Claim Load
    TotalPenaltyAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalPenaltyAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalPenaltyAmount
    AP_CLAIM_2.PENALTY_AMT
    Received Claim Load
    TotalPenaltyAmount
    AP_CLAIM_2.PENALTY_AMT

    TotalCobPrimaryInsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR DME Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR Part B Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalCobPrimaryInsuranceAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalCobPrimaryInsuranceAmount
    AP_CLAIM.TOT_PRIM_INS_AMT
    Externally Adjudicated Pharmacy Claim Load
    TotalCobPrimaryInsuranceAmount
    AP_CLM_RX.TTL_PRIM_INS_AMT
    Received Claim Load
    TotalCobPrimaryInsuranceAmount
    AP_CLAIM.TOT_PRIM_INS_AMT
    Received Pharmacy Claim Load
    TotalCobPrimaryInsuranceAmount
    AP_CLM_RX.TTL_PRIM_INS_AMT

    TotalCobPrimaryInsurancePatientPortionAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS ACO Part B DME File Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS ACO Part B Physicians File Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS ACO Part D Prescription Drug File Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR DME Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Home Health Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Hospice Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Inpatient Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Outpatient Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Part B Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount

    NULL

    Externally Adjudicated Medical Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount
    AP_CLAIM.TOT_PRIM_PAT_PORT
    Received Claim Load
    TotalCobPrimaryInsurancePatientPortionAmount
    AP_CLAIM.TOT_PRIM_PAT_PORT

    ExternalClaim

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ExternalClaim

    NULL

    CMS ACO Part B DME File Load
    ExternalClaim

    NULL

    CMS ACO Part B Physicians File Load
    ExternalClaim

    NULL

    CMS ACO Part D Prescription Drug File Load
    ExternalClaim

    NULL

    CMS CJR DME Claim Load
    ExternalClaim

    NULL

    CMS CJR Home Health Claim Load
    ExternalClaim

    NULL

    CMS CJR Hospice Claim Load
    ExternalClaim

    NULL

    CMS CJR Inpatient Claim Load
    ExternalClaim

    NULL

    CMS CJR Outpatient Claim Load
    ExternalClaim

    NULL

    CMS CJR Part B Claim Load
    ExternalClaim

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    ExternalClaim

    NULL

    Data Aggregation Medical Claim Load
    ExternalClaim

    NULL

    Externally Adjudicated Medical Claim Load
    ExternalClaim

    NULL

    Payer System Medical Claim Load
    ExternalClaim

    NULL

    Received Claim Load
    ExternalClaim

    NULL

    ClaimHeaderId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ClaimHeaderId
    CMS ACO Part B DME File Load
    ClaimHeaderId
    CMS ACO Part B Physicians File Load
    ClaimHeaderId
    CMS ACO Part D Prescription Drug File Load
    ClaimHeaderId
    CMS CJR DME Claim Load
    ClaimHeaderId
    CMS CJR Home Health Claim Load
    ClaimHeaderId
    CMS CJR Hospice Claim Load
    ClaimHeaderId
    CMS CJR Inpatient Claim Load
    ClaimHeaderId
    CMS CJR Outpatient Claim Load
    ClaimHeaderId
    CMS CJR Part B Claim Load
    ClaimHeaderId
    CMS CJR Skilled Nursing Facility Claim Load
    ClaimHeaderId
    Data Aggregation Medical Claim Load
    ClaimHeaderId
    AP_CLAIM_3.CLAIM_HEADER_ID
    Data Aggregation Pharmacy Claim Load
    ClaimHeaderId
    AP_CLM_RX_2.CLAIM_HEADER_ID
    Externally Adjudicated Medical Claim Load
    ClaimHeaderId
    Externally Adjudicated Pharmacy Claim Load
    ClaimHeaderId
    Payer System Medical Claim Load
    ClaimHeaderId
    AP_CLAIM_3.CLAIM_HEADER_ID
    Payer System Pharmacy Claim Load
    ClaimHeaderId
    AP_CLM_RX_2.CLAIM_HEADER_ID
    Received Claim Load
    ClaimHeaderId
    Received Pharmacy Claim Load
    ClaimHeaderId

    AdjustmentSequence

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustmentSequence
    CMS ACO Part B DME File Load
    AdjustmentSequence
    CMS ACO Part B Physicians File Load
    AdjustmentSequence
    CMS ACO Part D Prescription Drug File Load
    AdjustmentSequence
    CMS CJR DME Claim Load
    AdjustmentSequence
    CMS CJR Home Health Claim Load
    AdjustmentSequence
    CMS CJR Hospice Claim Load
    AdjustmentSequence
    CMS CJR Inpatient Claim Load
    AdjustmentSequence
    CMS CJR Outpatient Claim Load
    AdjustmentSequence
    CMS CJR Part B Claim Load
    AdjustmentSequence
    CMS CJR Skilled Nursing Facility Claim Load
    AdjustmentSequence
    Data Aggregation Medical Claim Load
    AdjustmentSequence
    AP_CLAIM_3.ADJ_SEQUENCE
    Data Aggregation Pharmacy Claim Load
    AdjustmentSequence
    AP_CLM_RX_2.ADJ_SEQUENCE
    Externally Adjudicated Medical Claim Load
    AdjustmentSequence
    Externally Adjudicated Pharmacy Claim Load
    AdjustmentSequence
    Payer System Medical Claim Load
    AdjustmentSequence
    AP_CLAIM_3.ADJ_SEQUENCE
    Payer System Pharmacy Claim Load
    AdjustmentSequence
    AP_CLM_RX_2.ADJ_SEQUENCE
    Received Claim Load
    AdjustmentSequence
    Received Pharmacy Claim Load
    AdjustmentSequence

    SourceKey

    : integer
    Links to SourceDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SourceId
    SourceIdType
    CMS ACO Part B DME File Load
    SourceId
    SourceIdType
    CMS ACO Part B Physicians File Load
    SourceId
    SourceIdType
    CMS ACO Part D Prescription Drug File Load
    SourceId
    SourceIdType
    CMS CJR DME Claim Load
    SourceId
    SourceIdType
    CMS CJR Home Health Claim Load
    SourceId
    SourceIdType
    CMS CJR Hospice Claim Load
    SourceId
    SourceIdType
    CMS CJR Inpatient Claim Load
    SourceId
    SourceIdType
    CMS CJR Outpatient Claim Load
    SourceId
    SourceIdType
    CMS CJR Part B Claim Load
    SourceId
    SourceIdType
    CMS CJR Skilled Nursing Facility Claim Load
    SourceId
    SourceIdType
    Data Aggregation Medical Claim Load
    SourceId
    AP_CLAIM_3.SOURCE_ORG_ID
    SourceIdType
    Data Aggregation Pharmacy Claim Load
    SourceId
    AP_CLM_RX_2.SOURCE_ORG_ID
    SourceIdType
    Externally Adjudicated Medical Claim Load
    SourceId
    SourceIdType
    Externally Adjudicated Pharmacy Claim Load
    SourceId
    SourceIdType
    Payer System Medical Claim Load
    SourceId
    AP_CLAIM_3.SOURCE_ORG_ID
    SourceIdType
    Payer System Pharmacy Claim Load
    SourceId
    AP_CLM_RX_2.SOURCE_ORG_ID
    SourceIdType
    Received Claim Load
    SourceId
    SourceIdType
    Received Pharmacy Claim Load
    SourceId
    SourceIdType

    IsPatientSubscriber

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsPatientSubscriber

    NULL

    CMS ACO Part B DME File Load
    IsPatientSubscriber

    NULL

    CMS ACO Part B Physicians File Load
    IsPatientSubscriber

    NULL

    CMS ACO Part D Prescription Drug File Load
    IsPatientSubscriber

    NULL

    CMS CJR DME Claim Load
    IsPatientSubscriber

    NULL

    CMS CJR Home Health Claim Load
    IsPatientSubscriber

    NULL

    CMS CJR Hospice Claim Load
    IsPatientSubscriber

    NULL

    CMS CJR Inpatient Claim Load
    IsPatientSubscriber

    NULL

    CMS CJR Outpatient Claim Load
    IsPatientSubscriber

    NULL

    CMS CJR Part B Claim Load
    IsPatientSubscriber

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    IsPatientSubscriber

    NULL

    Data Aggregation Medical Claim Load
    IsPatientSubscriber

    NULL

    Data Aggregation Pharmacy Claim Load
    IsPatientSubscriber

    NULL

    Externally Adjudicated Medical Claim Load
    IsPatientSubscriber
    CLM_VALUES_3.RECORD_ID
    CLM_VALUES_3.SUB_SELF_REL_CODE

    If SUB_SELF_REL_CODE = "18" then 1 Otherwise if RECORD_ID is not NULL then 0

    Externally Adjudicated Pharmacy Claim Load
    IsPatientSubscriber

    NULL

    Payer System Medical Claim Load
    IsPatientSubscriber

    NULL

    Payer System Pharmacy Claim Load
    IsPatientSubscriber

    NULL

    Received Claim Load
    IsPatientSubscriber
    CLM_VALUES_3.RECORD_ID
    CLM_VALUES_3.SUB_SELF_REL_CODE

    If SUB_SELF_REL_CODE = "18" then 1 Otherwise if RECORD_ID is not NULL then 0

    Received Pharmacy Claim Load
    IsPatientSubscriber

    NULL

    IsClinicallyValid

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsClinicallyValid
    MsspPartAClaimsHeader.BENE_EQTBL_BIC_HICN_NUM
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD
    MsspPartAClaimsHeader.CLM_EFCTV_DT
    MsspPartAClaimsHeader.CLM_FROM_DT
    MsspPartAClaimsHeader.CLM_THRU_DT
    MsspPartAClaimsHeader.PRVDR_OSCAR_NUM

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ???¢ã¡ã? 1-Cancelation Claim and with the same PRVDR_OSCAR_NUM, CLM_FROM_DT, CLM_THRU_DT, and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS ACO Part B DME File Load
    IsClinicallyValid
    MsspPartBDme.BENE_EQTBL_BIC_HICN_NUM
    MsspPartBDme.CLM_ADJSMT_TYPE_CD
    MsspPartBDme.CLM_CNTL_NUM
    MsspPartBDme.CLM_EFCTV_DT

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠ 1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS ACO Part B Physicians File Load
    IsClinicallyValid
    MsspPartBPhysicians.BENE_EQTBL_BIC_HICN_NUM
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_CNTL_NUM
    MsspPartBPhysicians.CLM_EFCTV_DT

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠ 1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS ACO Part D Prescription Drug File Load
    IsClinicallyValid
    MsspPartD.CLM_ADJSMT_TYPE_CD
    MsspPartD.CLM_DSPNSNG_STUS_CD
    MsspPartD.CLM_IDR_LD_DT
    MsspPartD.CLM_LINE_FROM_DT
    MsspPartD.CLM_LINE_RX_FILL_NUM
    MsspPartD.CLM_LINE_RX_SRVC_RFRNC_NUM
    MsspPartD.CLM_SRVC_PRVDR_GNRC_ID_NUM
    MsspPartD.PRVDR_SRVC_ID_QLFYR_CD

    If the claim has the most recent CLM_IDR_LD_DT among claims having the same CLM_LINE_FROM_DT, PRVDR_SRVC_ID_QLFYR_CD, CLM_SRVC_PRVDR_GNRC_ID_NUM, CLM_DSPNSNG_STUS_CD, CLM_LINE_RX_SRVC_RFRNC_NUM, and CLM_LINE_RX_FILL_NUM and CLM_ADJSMT_TYPE_CD ≠ 1-Cancelation Claim then 1 Otherwise 0

    CMS CJR DME Claim Load
    IsClinicallyValid

    1

    CMS CJR Home Health Claim Load
    IsClinicallyValid

    1

    CMS CJR Hospice Claim Load
    IsClinicallyValid

    1

    CMS CJR Inpatient Claim Load
    IsClinicallyValid

    1

    CMS CJR Outpatient Claim Load
    IsClinicallyValid

    1

    CMS CJR Part B Claim Load
    IsClinicallyValid

    1

    CMS CJR Skilled Nursing Facility Claim Load
    IsClinicallyValid

    1

    Data Aggregation Medical Claim Load
    IsClinicallyValid
    AP_CLAIM_3.IS_CLINICALLY_VALID_YN
    Data Aggregation Pharmacy Claim Load
    IsClinicallyValid
    AP_CLM_RX_2.IS_CLINICALLY_VALID_YN
    Externally Adjudicated Medical Claim Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Externally Adjudicated Pharmacy Claim Load
    IsClinicallyValid
    AP_CLM_RX.ADJUST_BY_CLAIM_ID
    AP_CLM_RX.CLM_STATUS_C
    AP_CLM_RX.INVALID_CLM_YN
    AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    AP_CLM_RX.OVERRIDE_INVALID_CLM_YN
    AP_CLM_RX_2.IS_CLINICALLY_VALID_YN

    If AP_CLM_RX.ADJUST_BY_CLAIM_ID is not null then 0 Otherwise if AP_CLM_RX.ORIG_OF_REV_CLAIM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if AP_CLM_RX.CLM_STATUS_C = 3-"Denied" then 0 Otherwise if AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN = "Y" then 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" then 1 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" then 0 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" then 0 Otherwise 1

    Payer System Medical Claim Load
    IsClinicallyValid
    AP_CLAIM_3.IS_CLINICALLY_VALID_YN
    Payer System Pharmacy Claim Load
    IsClinicallyValid
    AP_CLM_RX_2.IS_CLINICALLY_VALID_YN
    Received Claim Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Received Pharmacy Claim Load
    IsClinicallyValid
    AP_CLM_RX.ADJUST_BY_CLAIM_ID
    AP_CLM_RX.CLM_STATUS_C
    AP_CLM_RX.INVALID_CLM_YN
    AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN
    AP_CLM_RX.ORIG_OF_REV_CLAIM_ID
    AP_CLM_RX.OVERRIDE_INVALID_CLM_YN

    If AP_CLM_RX.ADJUST_BY_CLAIM_ID is not null then 0 Otherwise if AP_CLM_RX.ORIG_OF_REV_CLAIM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if AP_CLM_RX.CLM_STATUS_C = 3-"Denied" then 0 Otherwise if AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN = "Y" then 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" then 1 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" then 0 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" then 0 Otherwise 1

    IsClinicallyValidForcedToZero

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsClinicallyValidForcedToZero
    CMS ACO Part B DME File Load
    IsClinicallyValidForcedToZero
    CMS ACO Part B Physicians File Load
    IsClinicallyValidForcedToZero
    CMS ACO Part D Prescription Drug File Load
    IsClinicallyValidForcedToZero
    CMS CJR DME Claim Load
    IsClinicallyValidForcedToZero
    CMS CJR Home Health Claim Load
    IsClinicallyValidForcedToZero
    CMS CJR Hospice Claim Load
    IsClinicallyValidForcedToZero
    CMS CJR Inpatient Claim Load
    IsClinicallyValidForcedToZero
    CMS CJR Outpatient Claim Load
    IsClinicallyValidForcedToZero
    CMS CJR Part B Claim Load
    IsClinicallyValidForcedToZero
    CMS CJR Skilled Nursing Facility Claim Load
    IsClinicallyValidForcedToZero
    Data Aggregation Medical Claim Load
    IsClinicallyValidForcedToZero
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN
    Data Aggregation Pharmacy Claim Load
    IsClinicallyValidForcedToZero
    AP_CLM_RX.INVALID_CLM_YN
    AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN
    AP_CLM_RX.OVERRIDE_INVALID_CLM_YN
    Externally Adjudicated Medical Claim Load
    IsClinicallyValidForcedToZero
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If OVERRIDE_INVALID_YN = "N" THEN 0 Otherwise if OVERRIDE_INVALID_YN = "Y" THEN 1 Otherwise if INVALID_YN = "Y" THEN 1 Otherwise 0

    Externally Adjudicated Pharmacy Claim Load
    IsClinicallyValidForcedToZero
    AP_CLM_RX.INVALID_CLM_YN
    AP_CLM_RX.OVERRIDE_INVALID_CLM_YN

    If AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" THEN 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" THEN 1 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" THEN 1 Otherwise 0

    Payer System Medical Claim Load
    IsClinicallyValidForcedToZero
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN
    Payer System Pharmacy Claim Load
    IsClinicallyValidForcedToZero
    AP_CLM_RX.INVALID_CLM_YN
    AP_CLM_RX.IS_INVLD_ADJ_SEQ_RX_YN
    AP_CLM_RX.OVERRIDE_INVALID_CLM_YN
    Received Claim Load
    IsClinicallyValidForcedToZero
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If OVERRIDE_INVALID_YN = "N" THEN 0 Otherwise if OVERRIDE_INVALID_YN = "Y" THEN 1 Otherwise if INVALID_YN = "Y" THEN 1 Otherwise 0

    Received Pharmacy Claim Load
    IsClinicallyValidForcedToZero
    AP_CLM_RX.INVALID_CLM_YN
    AP_CLM_RX.OVERRIDE_INVALID_CLM_YN

    If AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "N" THEN 0 Otherwise if AP_CLM_RX.OVERRIDE_INVALID_CLM_YN = "Y" THEN 1 Otherwise if AP_CLM_RX.INVALID_CLM_YN = "Y" THEN 1 Otherwise 0

    IsCurrentInClaimSequence

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsCurrentInClaimSequence

    NULL

    CMS ACO Part B DME File Load
    IsCurrentInClaimSequence

    NULL

    CMS ACO Part B Physicians File Load
    IsCurrentInClaimSequence

    NULL

    CMS ACO Part D Prescription Drug File Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR DME Claim Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR Home Health Claim Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR Hospice Claim Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR Inpatient Claim Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR Outpatient Claim Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR Part B Claim Load
    IsCurrentInClaimSequence

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    IsCurrentInClaimSequence

    NULL

    Data Aggregation Medical Claim Load
    IsCurrentInClaimSequence

    NULL

    Externally Adjudicated Medical Claim Load
    IsCurrentInClaimSequence

    NULL

    Payer System Medical Claim Load
    IsCurrentInClaimSequence

    NULL

    Received Claim Load
    IsCurrentInClaimSequence

    NULL

    IsCorrectionOfPayee

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsCorrectionOfPayee

    NULL

    CMS ACO Part B DME File Load
    IsCorrectionOfPayee

    NULL

    CMS ACO Part B Physicians File Load
    IsCorrectionOfPayee

    NULL

    CMS ACO Part D Prescription Drug File Load
    IsCorrectionOfPayee

    NULL

    CMS CJR DME Claim Load
    IsCorrectionOfPayee

    NULL

    CMS CJR Home Health Claim Load
    IsCorrectionOfPayee

    NULL

    CMS CJR Hospice Claim Load
    IsCorrectionOfPayee

    NULL

    CMS CJR Inpatient Claim Load
    IsCorrectionOfPayee

    NULL

    CMS CJR Outpatient Claim Load
    IsCorrectionOfPayee

    NULL

    CMS CJR Part B Claim Load
    IsCorrectionOfPayee

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    IsCorrectionOfPayee

    NULL

    Externally Adjudicated Medical Claim Load
    IsCorrectionOfPayee

    0

    Received Claim Load
    IsCorrectionOfPayee
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_ADJST_CLM_ID is NULL and AP_CLAIM.ORIG_REV_CLM_ID is NULL and AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not null then 1 Otherwise 0

    IsValidClaimSequence

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Default value
    1
    Delete value
    0

    IsFormTypeFromSourceData

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsFormTypeFromSourceData
    CMS ACO Part B DME File Load
    IsFormTypeFromSourceData
    CMS ACO Part B Physicians File Load
    IsFormTypeFromSourceData
    CMS ACO Part D Prescription Drug File Load
    IsFormTypeFromSourceData
    CMS CJR DME Claim Load
    IsFormTypeFromSourceData
    CMS CJR Home Health Claim Load
    IsFormTypeFromSourceData
    CMS CJR Hospice Claim Load
    IsFormTypeFromSourceData
    CMS CJR Inpatient Claim Load
    IsFormTypeFromSourceData
    CMS CJR Outpatient Claim Load
    IsFormTypeFromSourceData
    CMS CJR Part B Claim Load
    IsFormTypeFromSourceData
    CMS CJR Skilled Nursing Facility Claim Load
    IsFormTypeFromSourceData
    Data Aggregation Medical Claim Load
    IsFormTypeFromSourceData
    Externally Adjudicated Medical Claim Load
    IsFormTypeFromSourceData
    Payer System Medical Claim Load
    IsFormTypeFromSourceData
    Received Claim Load
    IsFormTypeFromSourceData

    WasPayeeCorrected

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    WasPayeeCorrected

    NULL

    CMS ACO Part B DME File Load
    WasPayeeCorrected

    NULL

    CMS ACO Part B Physicians File Load
    WasPayeeCorrected

    NULL

    CMS ACO Part D Prescription Drug File Load
    WasPayeeCorrected

    NULL

    CMS CJR DME Claim Load
    WasPayeeCorrected

    NULL

    CMS CJR Home Health Claim Load
    WasPayeeCorrected

    NULL

    CMS CJR Hospice Claim Load
    WasPayeeCorrected

    NULL

    CMS CJR Inpatient Claim Load
    WasPayeeCorrected

    NULL

    CMS CJR Outpatient Claim Load
    WasPayeeCorrected

    NULL

    CMS CJR Part B Claim Load
    WasPayeeCorrected

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    WasPayeeCorrected

    NULL

    Externally Adjudicated Medical Claim Load
    WasPayeeCorrected

    0

    Received Claim Load
    WasPayeeCorrected
    AP_CLAIM_2.CLAIM_ID

    If there exists a claim where its ORIG_ACT_ADJ_CLM_ID is this claim's Id then 1 Otherwise 0

    IsBehavioralHealth

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsBehavioralHealth

    NULL

    CMS ACO Part B DME File Load
    IsBehavioralHealth

    NULL

    CMS ACO Part B Physicians File Load
    IsBehavioralHealth

    NULL

    CMS ACO Part D Prescription Drug File Load
    IsBehavioralHealth

    NULL

    CMS CJR DME Claim Load
    IsBehavioralHealth

    NULL

    CMS CJR Home Health Claim Load
    IsBehavioralHealth

    NULL

    CMS CJR Hospice Claim Load
    IsBehavioralHealth

    NULL

    CMS CJR Inpatient Claim Load
    IsBehavioralHealth

    NULL

    CMS CJR Outpatient Claim Load
    IsBehavioralHealth

    NULL

    CMS CJR Part B Claim Load
    IsBehavioralHealth

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    IsBehavioralHealth

    NULL

    Data Aggregation Medical Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Data Aggregation Pharmacy Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Externally Adjudicated Medical Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Externally Adjudicated Pharmacy Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Payer System Medical Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Payer System Pharmacy Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Received Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    Received Pharmacy Claim Load
    IsBehavioralHealth
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 2-Behavioral Health then 1 Otherwise 0

    IsSubstanceAbuse

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsSubstanceAbuse

    NULL

    CMS ACO Part B DME File Load
    IsSubstanceAbuse

    NULL

    CMS ACO Part B Physicians File Load
    IsSubstanceAbuse

    NULL

    CMS ACO Part D Prescription Drug File Load
    IsSubstanceAbuse

    NULL

    CMS CJR DME Claim Load
    IsSubstanceAbuse

    NULL

    CMS CJR Home Health Claim Load
    IsSubstanceAbuse

    NULL

    CMS CJR Hospice Claim Load
    IsSubstanceAbuse

    NULL

    CMS CJR Inpatient Claim Load
    IsSubstanceAbuse

    NULL

    CMS CJR Outpatient Claim Load
    IsSubstanceAbuse

    NULL

    CMS CJR Part B Claim Load
    IsSubstanceAbuse

    NULL

    CMS CJR Skilled Nursing Facility Claim Load
    IsSubstanceAbuse

    NULL

    Data Aggregation Medical Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0

    Data Aggregation Pharmacy Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0

    Externally Adjudicated Medical Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0

    Externally Adjudicated Pharmacy Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0

    Payer System Medical Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0

    Payer System Pharmacy Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0

    Received Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = 1-Substance Abuse then 1 Otherwise 0

    Received Pharmacy Claim Load
    IsSubstanceAbuse
    AP_CLAIM_ANALYTICS_SENS.SENSITIVITY_TYPE_C

    If there exists a row for the claim where SENSITIVITY_TYPE_C = Substance Abuse then 1 Otherwise 0

    IsInterpretedClaimTypeFromSourceData

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsInterpretedClaimTypeFromSourceData
    CMS ACO Part B DME File Load
    IsInterpretedClaimTypeFromSourceData
    CMS ACO Part B Physicians File Load
    IsInterpretedClaimTypeFromSourceData
    CMS ACO Part D Prescription Drug File Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR DME Claim Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR Home Health Claim Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR Hospice Claim Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR Inpatient Claim Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR Outpatient Claim Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR Part B Claim Load
    IsInterpretedClaimTypeFromSourceData
    CMS CJR Skilled Nursing Facility Claim Load
    IsInterpretedClaimTypeFromSourceData
    Data Aggregation Medical Claim Load
    IsInterpretedClaimTypeFromSourceData
    Externally Adjudicated Medical Claim Load
    IsInterpretedClaimTypeFromSourceData
    Payer System Medical Claim Load
    IsInterpretedClaimTypeFromSourceData
    Received Claim Load
    IsInterpretedClaimTypeFromSourceData

    IsIsSubstanceAbuseFromSourceData

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    1
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsIsSubstanceAbuseFromSourceData
    CMS ACO Part B DME File Load
    IsIsSubstanceAbuseFromSourceData
    CMS ACO Part B Physicians File Load
    IsIsSubstanceAbuseFromSourceData
    CMS ACO Part D Prescription Drug File Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR DME Claim Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR Home Health Claim Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR Hospice Claim Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR Inpatient Claim Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR Outpatient Claim Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR Part B Claim Load
    IsIsSubstanceAbuseFromSourceData
    CMS CJR Skilled Nursing Facility Claim Load
    IsIsSubstanceAbuseFromSourceData
    Data Aggregation Medical Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Data Aggregation Pharmacy Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Externally Adjudicated Medical Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Externally Adjudicated Pharmacy Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Payer System Medical Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Payer System Pharmacy Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Received Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    Received Pharmacy Claim Load
    IsIsSubstanceAbuseFromSourceData

    1

    IsIsBehavioralHealthFromSourceData

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    1
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsIsBehavioralHealthFromSourceData
    CMS ACO Part B DME File Load
    IsIsBehavioralHealthFromSourceData
    CMS ACO Part B Physicians File Load
    IsIsBehavioralHealthFromSourceData
    CMS ACO Part D Prescription Drug File Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR DME Claim Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR Home Health Claim Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR Hospice Claim Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR Inpatient Claim Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR Outpatient Claim Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR Part B Claim Load
    IsIsBehavioralHealthFromSourceData
    CMS CJR Skilled Nursing Facility Claim Load
    IsIsBehavioralHealthFromSourceData
    Data Aggregation Medical Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Data Aggregation Pharmacy Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Externally Adjudicated Medical Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Externally Adjudicated Pharmacy Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Payer System Medical Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Payer System Pharmacy Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Received Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    Received Pharmacy Claim Load
    IsIsBehavioralHealthFromSourceData

    1

    IsNonCclClaim

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    1
    Delete value
    1
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsNonCclClaim
    CMS ACO Part B DME File Load
    IsNonCclClaim
    CMS ACO Part B Physicians File Load
    IsNonCclClaim
    CMS ACO Part D Prescription Drug File Load
    IsNonCclClaim
    CMS CJR DME Claim Load
    IsNonCclClaim
    CMS CJR Home Health Claim Load
    IsNonCclClaim
    CMS CJR Hospice Claim Load
    IsNonCclClaim
    CMS CJR Inpatient Claim Load
    IsNonCclClaim
    CMS CJR Outpatient Claim Load
    IsNonCclClaim
    CMS CJR Part B Claim Load
    IsNonCclClaim
    CMS CJR Skilled Nursing Facility Claim Load
    IsNonCclClaim
    Externally Adjudicated Medical Claim Load
    IsNonCclClaim
    Externally Adjudicated Pharmacy Claim Load
    IsNonCclClaim
    Received Claim Load
    IsNonCclClaim
    Received Pharmacy Claim Load
    IsNonCclClaim

    Count

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    1
    Delete value
    0

    _CreationInstant

    : date/time

    Properties

    Data type
    date/time
    SQL Server data type
    datetime
    Allows null
    Yes

    _LastUpdatedInstant

    : date/time

    Properties

    Data type
    date/time
    SQL Server data type
    datetime
    Allows null
    Yes

    _IsInferred

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Default value
    0

    _IsDeleted

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Default value
    0

    _PrimaryPackageToImpactRecord

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    empty string

    _MostRecentPackageToImpactRecord

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    empty string

    _NumberOfSources

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    No
    Default value
    0

    _HasSourceClarity

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _DeletedFromSourceClarity

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _HasSourceCmsAco

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _DeletedFromSourceCmsAco

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _HasSourceCmsCjr

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _DeletedFromSourceCmsCjr

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0